NPIMap

Organization Active NPI

Johnson Regional Medical Center

  • Rehabilitation Hospital Unit
  • Clarksville, AR
National Provider Identifier
1841249943
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
JOHNSON REGIONAL MEDICAL CENTER
Doing business as
JRMC Rehab
Practice address
1100 E Poplar St
Clarksville, AR 72830-4419
Phone
(479) 754-5454
Fax
(479) 754-5311
NPI assigned
May 8, 2006
Organization subpart
Yes
Parent organization
JOHNSON REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Robert Larry Morse
Title
Administrator
Phone
(479) 754-5454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X AR Primary

Addresses

Primary practice location

1100 E Poplar St
Clarksville, AR 72830-4419

Mailing address

PO Box 738
Clarksville, AR 72830-0738
Phone (479) 754-5454

Other names 1

  • JRMC Rehab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061221000244 AR Part A Provider - Hospital 1658360284 1 other NPI on this enrollment
Practice locations: Clarksville, AR

Hospital certification: CCN 04T002

Legal name
JOHNSON REGIONAL MEDICAL CENTER
Doing business as
JRMC REHAB UNIT
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1996 in AR
Enrollment address
1100 East Poplar Street
JRMC Rehab Unit
Clarksville, AR 72830-4419
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Johnson Regional Rehabilitation CenterCCN 04T002 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 2006

National Provider Directory

National Provider Directory
Tax ID family
Johnson Regional Med Ctr10 organizations share this tax ID, including this one
Part of
Johnson Regional Med Ctr

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Matthew McCormick Individual Corporate Director Jan 25, 2018
Rickey Casey Individual Corporate OfficerBoard Chairman Jan 1, 2018
Corporate Director May 10, 2004
Tommy W Hobbs Individual W-2 Managing Employee Sep 1, 2022
Lloyd Freeman Wish Individual Corporate Director Jun 28, 2007

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Johnson Regional Medical CenterClarksville, AR, CCN 040002 Hospital Operational/Managerial Control Jan 4, 2012
JRMC Senior Care UnitClarksville, AR, CCN 04S002 Hospital 5% Or Greater Direct Ownership Interest Jun 4, 2002

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1841249943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 738",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728300738",
            "telephone_number": "479-754-5454",
            "fax_number": "479-754-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E POPLAR ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728304419",
            "telephone_number": "479-754-5454",
            "fax_number": "479-754-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNSON REGIONAL MEDICAL CENTER",
        "enumeration_date": "2006-05-08",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "MORSE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LARRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "479-754-5454",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JRMC Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, AR

Sources for this page

Verify at the official NPI Registry.