KMJ Enterprises Benton I LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

709 Issued in AR

Legal business name

KMJ ENTERPRISES BENTON I LLC

Doing business as

StoneyBrook Health and Rehabilitation Center

Practice address

3300 Military Rd
Benton, AR 72015-2581

Phone

(501) 778-8282

Fax

(501) 778-1232

NPI assigned

Sep 30, 2005

Organization subpart

Yes

Parent organization

KMJ MANAGEMENTAs reported in NPPES

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

Authorized official

Name

Patricia Miller

Title

President/Ceo

Phone

(479) 636-5716

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• StoneyBrook Health and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1972590446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 MILITARY RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152581",
            "telephone_number": "501-778-8282",
            "fax_number": "501-778-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MILITARY RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152581",
            "telephone_number": "501-778-8282",
            "fax_number": "501-778-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMJ ENTERPRISES BENTON I LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KMJ MANAGEMENT",
        "enumeration_date": "2005-09-30",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "479-636-5716"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119717311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "StoneyBrook Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maranda Kirby, RECOVERY ASSISTANT
• Sarah B Kirby
• Kirk Medical Clinic
• Lawanda Kirkendoll, RECOVERY ASSISTANT
• Timmy Kitchen, RECOVERY ASSISTANT
• KMJ Enterprises Benton II LLC
• Sara N Knauf
• Juliana Kniep, LCSW
• Brittany Lynn Knight, PT
• Tarnisha Knight, QBHP

• Skilled Nursing Facility in Benton, AR
• Providers in Benton, 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 10, 2008; 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.