NPIMap

Organization Active NPI

Regional Care of Springfield West Park, LLC

Doing business as Brookhaven Health and Rehabilitation

  • Skilled Nursing Facility
  • Springfield, MO
National Provider Identifier
1891091070
Registry record updated Nov 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
038075 Issued in MO
Legal business name
REGIONAL CARE OF SPRINGFIELD WEST PARK, LLC
Doing business as
Brookhaven Health and Rehabilitation
Practice address
3405 W Mount Vernon St
Springfield, MO 65802-5241
Phone
(417) 874-9600
Fax
(417) 874-9601
NPI assigned
Feb 4, 2011
Last updated
Nov 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2014

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

Authorized official

Name
Mr. Phillip Cody Long
Title
Cfo
Phone
(479) 464-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 038075 MO Primary

Addresses

Primary practice location

3405 W Mount Vernon St
Springfield, MO 65802-5241

Mailing address

222 S 1St St
Rogers, AR 72756-4504
Phone (479) 464-0200

Other names 1

  • Brookhaven Health and Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brookhaven Health and Rehabilitation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3405 W Mount Vernon St
Springfield, MO 65802
Phone (417) 874-9600

NPI Registry JSON

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415318400000",
    "number": "1891091070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S 1ST ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564504",
            "telephone_number": "479-464-0200",
            "fax_number": "479-464-8098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 W MOUNT VERNON ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658025241",
            "telephone_number": "417-874-9600",
            "fax_number": "417-874-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL CARE OF SPRINGFIELD WEST PARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-04",
        "last_updated": "2014-11-07",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "479-464-0200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "038075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookhaven Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.