Russellville Holdings LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

4191 Issued in AR

Legal business name

RUSSELLVILLE HOLDINGS LLC

Practice address

1808 W Main St
Russellville, AR 72801-2724

Phone

(479) 968-2841

Fax

(479) 968-8189

NPI assigned

May 17, 2006

Organization subpart

Yes

Parent organization

RUSSELLVILLE HOLDINGS LLCAs reported in NPPES

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

Authorized official

Name

Terrance Dillon

Title

Assistant Secretary

Phone

(502) 596-7220

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Mary's Regional Medical Center Home Health Doing business as

Part of

Russellville Holdings LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Russellville Holdings LLC

  • Rehabilitation Hospital Unit
  • Russellville, AR
  • NPI 1376595132

  Member Of

  NPD member

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Russellville Holdings LLC

  • General Acute Care Hospital
  • Russellville, AR
  • NPI 1033160049
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ramona C Hodges, RD LD

  • Registered Dietitian
  • Russellville, AR
  • NPI 1588720320
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1881646644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 WEST MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012724",
            "telephone_number": "479-968-2841",
            "fax_number": "479-968-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012724",
            "telephone_number": "479-968-2841",
            "fax_number": "479-968-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELLVILLE HOLDINGS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RUSSELLVILLE HOLDINGS LLC",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "502-596-7220"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AR",
            "license": "4191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152827514",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Mary's Regional Medical Center Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Mary's Regional Medical Center Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Russellville Gastroenterology Clinic PA
• Russellville Gynecology Clinic
• Russellville Holdings LLC
• Russellville Holdings LLC
• Russellville Holdings LLC
• Russellville Pediatric & Adolescent Clinic, PA
• Russellville Physical Therapy, Inc
• Russellville Primary Care Clinic, Inc.
• Russellville School District
• Russellville Women'S Clinic

• Home Health Agency in Russellville, AR
• Providers in Russellville, AR by specialty
• Home Health Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.