Wagnon Place Health Facilities

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WAGNON PLACE HEALTH FACILITIES

Practice address

1440 East Church Street
Warren, AR 71671

Phone

(870) 226-6766

Fax

(870) 226-7430

NPI assigned

Oct 21, 2008

Organization subpart

No

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

Authorized official

Name

Joey Martin Wiggins

Title

President

Phone

(501) 305-3153

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1841442811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 HAWKINS DR",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721434802",
            "telephone_number": "501-305-3153",
            "fax_number": "501-279-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 EAST CHURCH STREET",
            "city": "WARREN",
            "state": "AR",
            "postal_code": "71671",
            "telephone_number": "870-226-6766",
            "fax_number": "870-226-7430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNON PLACE HEALTH FACILITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "JOEY",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-305-3153"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174597311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Medicine Cabinet, LLC
• Kristie Thomas
• Jamal Tolefree
• Andrew Turner
• University of Arkansas for Medical Sciences
• Wagnon Place Inc
• Walgreen Co
• Tiffany Wargo, APRN
• Warren Obstetrics and Gynecology, PA
• Warren School District

• All providers in Warren, AR
• Skilled Nursing Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.