Area Agency on Aging of Western Arkansas, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

0176 Issued in AR

Legal business name

AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC

Practice address

102 Bolan Street
Hartford, AR 72938

Phone

(479) 639-2997

NPI assigned

May 1, 2006

Last updated

Oct 2, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Rushing

Title

Supervisor of Corporate Services

Phone

(479) 783-4500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972560050. Details of each certification follow.

• CCN 041502 Hospice · Active · Details

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

CorporationNon-profit

Incorporated

Jun 21, 1979 in AR

Enrollment address

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

Other NPIs on the same Medicare enrollment 3

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

• Area Agency on Aging of Western Arkansas, Inc

  • Community Based Hospice Care Agency
  • Lavaca, AR
  • NPI 1154388999

  O20070201000026

  Same enrollment
• Area Agency on Aging of Western Arkansas, Inc

  • Community Based Hospice Care Agency
  • Greenwood, AR
  • NPI 1730146416

  O20070201000026

  Same enrollment
• Area Agency on Aging of Western Arkansas, Inc

  • Community Based Hospice Care Agency
  • Fort Smith, AR
  • NPI 1932166402

  O20070201000026

  Same enrollment

Listed as

Area Agency on Aging of Western Arkansas IncCCN 041502 · All quality measures

Ownership

Non-Profit

Certified

Jan 24, 1986

Medicare certification status

ActiveFrom the Provider of Services file

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.

Owners & managing parties with NPI records 1

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

• Charles W Craft, DO

  • Family Medicine Physician
  • Barling, AR
  • NPI 1013945138

  Corporate Director

  CMS ownership

Affiliated clinicians 1

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

• Philip Dunn Elangwe, M.D.

  • Family Medicine Physician
  • Fort Smith, AR
  • NPI 1780776435

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1972560050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 GARRISON AVE",
            "address_2": "PO BOX 1724",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729012514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 BOLAN STREET",
            "city": "HARTFORD",
            "state": "AR",
            "postal_code": "72938",
            "telephone_number": "479-639-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "RUSHING",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "SUPERVISOR OF CORPORATE SERVICES",
        "authorized_official_telephone_number": "479-783-4500"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AR",
            "license": "0176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Danielle Euston
• Alicia Ann Hammonds, M.S., CCC-SLP
• Hartford School District
• Jennifer Jean Levart, LPC
• Mazlynn Heathcare Service (mazlynn family heathceare)

• Community Based Hospice Care Agency in Hartford, AR
• Providers in Hartford, AR by specialty
• Community Based Hospice Care Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.