Jskmf, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

JSKMF, LLC

Practice address

903 Borgognoni Dr
Lake Village, AR 71653-1623

Phone

(870) 265-5337

NPI assigned

Jun 22, 2021

Organization subpart

No

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

Authorized official

Name

John Shannon Fleming

Title

Sole MBR

Phone

(501) 835-3988

Specialties & licenses 1

Addresses

Other names 1

• Lake Village Rehabilitation and Care Center Doing business as

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1922677129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 BORGOGNONI DR",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716531623",
            "telephone_number": "870-265-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 BORGOGNONI DR",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716531623",
            "telephone_number": "870-265-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSKMF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "501-835-3988"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Village Rehabilitation and Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Johnson, FNP-BC
• Emily Keith Johnson, RD
• Kera Johnson
• Tracy Johnson, PTA
• Stephanie Jones
• Lab One LLC
• Lake Village Clinic PA
• Lake Village Drugstore, Inc.
• Lake Village Healthcare Center, LLC
• Lake Village Operations LLC

• Skilled Nursing Facility in Lake Village, AR
• Providers in Lake Village, 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 22, 2021; 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.