NPIMap

Organization Active NPI

Diversicare Pinedale, LLC

Doing business as Newport Healthcare and Rehabilitation Center

  • Skilled Nursing Facility
  • Newport, AR
National Provider Identifier
1922096593
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
654 Issued in AR
Legal business name
DIVERSICARE PINEDALE, LLC
Doing business as
Newport Healthcare and Rehabilitation Center
Practice address
1311 N Pecan St
Newport, AR 72112-2816
Phone
(870) 523-9514
Fax
(870) 523-8198
NPI assigned
Oct 7, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Raymond L. Tyler Jr.
Title
Executive Vice President and Coo
Phone
(615) 771-7575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 654 AR Primary

Addresses

Primary practice location

1311 N Pecan St
Newport, AR 72112-2816

Mailing address

1311 N Pecan St
Newport, AR 72112-2816
Phone (870) 523-9514

Other names 1

  • Newport Healthcare and Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922096593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 N PECAN ST",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721122816",
            "telephone_number": "870-523-9514",
            "fax_number": "870-523-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 N PECAN ST",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721122816",
            "telephone_number": "870-523-9514",
            "fax_number": "870-523-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE PINEDALE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT AND COO",
        "authorized_official_telephone_number": "615-771-7575",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newport Healthcare and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.