NPIMap

Area Agency on Aging of Western Arkansas, Inc

Organization Active NPI Community Based Hospice Care Agency · Fort Smith, AR

NPI 1932166402 · NPPES record last updated Jul 7, 2025

Key facts

NPI
1932166402
Entity type
Organization (NPI type 2)
Primary specialty
Community Based Hospice Care Agency 251G00000X
License
0176 (AR)
Legal business name
AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC
Practice address
3600 Wheeler Ave Ste 2
Fort Smith, AR 72901-6621
Phone
(479) 783-4500
Fax
(855) 515-7414
NPI assigned
Apr 28, 2006
Organization subpart
No

Authorized official

Name
Dana Callaway
Title
Cfo
Phone
(479) 424-2020

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 21

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

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Hospice

Listed as
Area Agency on Aging of Western Arkansas Inc CCN 041502
Ownership
Non-Profit
Certified
Jan 24, 1986
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR

Hospice certification: CCN 041502

Legal name
AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 24, 1986
Last certification
Jun 3, 2021
Ownership / control type
Proprietary - Other
Organization structure
Corporation · Non-profit
Incorporated
Jun 21, 1979 in AR
Enrollment address
3600 Wheeler Ave
Ste 2
Fort Smith, AR 72901-6621

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jim Petty
Individual 		Corporate Director
Board Member		 Oct 22, 2020
Ricky R Green
Individual 		Corporate Director
Board Member		 Jul 25, 2019
Candice Settle
Individual 		Corporate Director
Board Member		 Feb 25, 2021
Robert Herrera
Individual 		Corporate Director
Board Member		 Apr 27, 2017
Jake Sibley
Individual 		Corporate Officer
2ND Vice Chairperson		 Jan 28, 2021
Charles Craft
Individual 		Corporate Director
Medical Director		 Aug 25, 2015
Jennifer Hallum
Individual 		Corporate Officer
Ceo/Administrator		 Sep 3, 2015
W-2 Managing Employee
Ad;Ceo		 Sep 3, 2015
Phillip Merry
Individual 		Corporate Officer
1St Vice Chairperson/Sec-Treasurer		 Jan 28, 2021
Sharon Brooks
Individual 		Corporate Director
Board Member		 Feb 23, 2011
Dana Callaway
Individual 		Corporate Officer
Chief Financial Officer		 Jun 22, 2016
W-2 Managing Employee
Chief Financial Officer		 Jun 22, 2016
Mont Sagely
Individual 		Corporate Director
Board Member		 Feb 23, 2023
Doug Kinslow
Individual 		Corporate Director
Board Member		 Apr 27, 2017
T.R. McNutt
Individual 		Corporate Officer
Chairman of the Board		 Jan 28, 2021

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Visiting Nurses Agency of Western Arkansas, Inc
Mena, AR · CCN 047162		 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jun 23, 1977
Area Agency on Aging of Western Arkansas, Inc
Paris, AR · CCN 047156		 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jun 20, 1979
Area Agency on Aging of Western Arkansas, Inc
Fort Smith, AR · CCN 047034		 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jun 20, 1979

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070201000026 AR Part a Provider - Hospice 5991707127 3 other NPIs on this enrollment
Practice locations: Fort Smith, AR

National Provider Directory

Tax ID family
Area Agency on Aging of Western Ar Inc (23 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 0176 AR Yes

Addresses

Primary practice location

3600 Wheeler Ave Ste 2
Fort Smith, AR 72901-6621

Mailing address

PO Box 1724
Fort Smith, AR 72902-1724
Phone (479) 783-4500

Other providers in Fort Smith, AR

All providers in Fort Smith, AR · Community Based Hospice Care Agency in Arkansas

Sources for this page

Verify at the official NPI Registry.