Stoneridge Health and Rehab Center

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

0798 Issued in AR

Legal business name

STONERIDGE HEALTH AND REHAB CENTER

Doing business as

StoneRidge Health & Rehab Center

Practice address

4017 Franklin
College Station, AR 72053

Phone

(501) 490-1533

Fax

(501) 490-0608

NPI assigned

Jan 10, 2007

Last updated

Dec 9, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kurt L Luth

Title

Registered Agent

Phone

(501) 833-5627

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• StoneRidge Health & Rehab Center Doing business as

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418083200000",
    "number": "1851440309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 LANTRIP RD",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721204161",
            "telephone_number": "501-833-5627",
            "fax_number": "501-835-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4017 FRANKLIN",
            "city": "COLLEGE STATION",
            "state": "AR",
            "postal_code": "72053",
            "telephone_number": "501-490-1533",
            "fax_number": "501-490-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONERIDGE HEALTH AND REHAB CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2014-12-09",
        "status": "A",
        "authorized_official_last_name": "LUTH",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "501-833-5627",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "AR",
            "license": "0798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162852311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "StoneRidge Health & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crass Inc
• Jefferson Comprehensive Care System, Inc (College Station Center)
• Jefferson Comprehensive Care System, Inc. (College Station Dental)
• Stoneridge Operations, LLC (Stoneridge Nursing and Rehabilitation Center)

• Nursing Facility/Intermediate Care Facility in College Station, AR
• Providers in College Station, AR by specialty
• Nursing Facility/Intermediate Care Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; 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.