KMJ Enterprises Benton II LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

711 Issued in AR

Legal business name

KMJ ENTERPRISES BENTON II LLC

Doing business as

Kenwood Health and Rehabilitation Center

Practice address

809 Kenwood Rd
Benton, AR 72015-2337

Phone

(501) 778-7417

Fax

(501) 778-4471

NPI assigned

Oct 3, 2005

Last updated

Jun 10, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

KMJ MANAGEMENTAs reported in NPPES

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

Authorized official

Name

Patricia Miller

Title

President/Ceo

Phone

(479) 636-5716

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kenwood Health and Rehabilitation Center Doing business as

Locations

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1871580050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720180280",
            "telephone_number": "501-778-7417",
            "fax_number": "501-778-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 KENWOOD RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152337",
            "telephone_number": "501-778-7417",
            "fax_number": "501-778-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMJ ENTERPRISES BENTON II LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KMJ MANAGEMENT",
        "enumeration_date": "2005-10-03",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "479-636-5716"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119719311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenwood Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah B Kirby
• Kirk Medical Clinic
• Lawanda Kirkendoll, RECOVERY ASSISTANT
• Timmy Kitchen, RECOVERY ASSISTANT
• KMJ Enterprises Benton I LLC (StoneyBrook Health and Rehabilitation Center)
• Sara N Knauf
• Juliana Kniep, LCSW
• Brittany Lynn Knight, PT
• Tarnisha Knight, QBHP
• Lachelle Knighton

• Skilled Nursing Facility in Benton, AR
• Providers in Benton, AR by specialty
• Skilled Nursing Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.