State of Arkansas

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

AR4030 Issued in AR

Legal business name

STATE OF ARKANSAS

Doing business as

Izard County Health Unit

Practice address

1015 Haley St
Izard County Health Unit
Melbourne, AR 72556-8211

Phone

(870) 368-7790

Fax

(870) 368-7060

NPI assigned

Jul 22, 2006

Last updated

Aug 13, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

STATE OF ARKANSASAs reported in NPPES

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

Authorized official

Name

Marilyn Evans, RN

Title

Home Health Administrator

Phone

(501) 661-2540

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Izard County Health Unit Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

State of Arkansas

Member of 1

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

• State of Arkansas

  dba Arkansas State Hospital

  • Psychiatric Hospital
  • Little Rock, AR
  • NPI 1295726156

  Member Of

  NPD member

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Kah Development 4, LLC

  dba CenterWell Home Health

  • Home Health Agency
  • Melbourne, AR
  • NPI 1609228717

  Sold to, 2016-08-01

  CMS change of ownership

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1932120128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 WEST 10TH STREET",
            "address_2": "SUITE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041764",
            "telephone_number": "501-661-2614",
            "fax_number": "501-661-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 HALEY ST",
            "address_2": "IZARD COUNTY HEALTH UNIT",
            "city": "MELBOURNE",
            "state": "AR",
            "postal_code": "725568211",
            "telephone_number": "870-368-7790",
            "fax_number": "870-368-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF ARKANSAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF ARKANSAS",
        "enumeration_date": "2006-07-22",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "HOME HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "501-661-2540",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AR",
            "license": "AR4030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104312514",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Izard County Health Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brandy Siebert, CMP
• Amylena Simmons, RN
• Kimberly Moser Smith, A.P.N
• Madalyn Dare Smith, COTA/L
• Sonya Wiles Dental Office, Inc
• Kyle Taylor, RECOVERY ASSISTANT
• Stephanie Lynn Teague, LPTA
• Michael Thompson, RECOVERY ASSISTANT
• Shawn M Tompkins, D.C.
• Total Resolutions Chiropractic

• Home Health Agency in Melbourne, AR
• Providers in Melbourne, 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 Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.