Victoria Healthcare Properties LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

728 Issued in AR

Legal business name

VICTORIA HEALTHCARE PROPERTIES LLC

Practice address

2010 Main
Van Buren, AR 72956-4957

Phone

(479) 474-6885

Fax

(479) 474-9523

NPI assigned

Aug 4, 2006

Organization subpart

No

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

Authorized official

Name

Jenny June Kilgore, CPA

Title

Controller

Phone

(479) 474-6885

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Crawford Healthcare & Rehabilitation Center Doing business as

Locations

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1922016872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 MAIN",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729564957",
            "telephone_number": "479-474-6885",
            "fax_number": "479-474-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 MAIN",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729564957",
            "telephone_number": "479-474-6885",
            "fax_number": "479-474-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA HEALTHCARE PROPERTIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "479-474-6885",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER INSURANCE",
            "identifier": "15326",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119736311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crawford Healthcare & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Van Buren Inc
• Van Buren Legacy LLC
• Van Buren Physical Therapy
• Van Buren SNF Operations LLC
• Michelle Vaughn
• Jessica D Waddle, RN
• Wal-Mart Stores Inc
• Wal-Mart Stores, Inc.
• Walgreen Co
• Walmart Inc.

• Skilled Nursing Facility in Van Buren, AR
• Providers in Van Buren, 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 Jan 11, 2010; 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.