Organization Active NPI

HBNC, Inc.

Doing business as Southridge Village Nursing and Rehab

  • Skilled Nursing Facility
  • Heber Springs, AR
National Provider Identifier
1982020541
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1042 Issued in AR
Legal business name
HBNC, INC.
Doing business as
Southridge Village Nursing and Rehab
Practice address
400 Southridge Pkwy
Heber Springs, AR 72543-8855
Phone
(501) 362-3185
Fax
(501) 362-2519
NPI assigned
Mar 6, 2014
Last updated
Nov 12, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
EAGLE HEALTH SYSTEMS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Authorized official

Name
Brandon Adams
Title
President
Phone
(501) 932-0050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1042 AR Primary

Addresses

Primary practice location

400 Southridge Pkwy
Heber Springs, AR 72543-8855

Mailing address

400 Southridge Pkwy
Heber Springs, AR 72543-8855
Phone (501) 362-3185

Other identifiers 1

IdentifierTypeStateIssuer
202100311MedicaidAR

Other names 1

  • SOUTHRIDGE VILLAGE NURSING AND REHAB Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140730000194 AR Part A Provider - Skilled Nursing Facility 5698991560 Practice locations: Herber Springs, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982020541. Details of each certification follow.

Skilled nursing facility certification: CCN 045196

Legal name
HBNC, INC.
Doing business as
SOUTHRIDGE VILLAGE NURSING AND REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1992
Last certification
Jul 25, 2024
Beds
122
Ownership / control type
Corporation
Multi-facility organization
Reliance Healthcare DBA Southridge Village
Organization structure
CorporationProprietary
Incorporated
Dec 3, 2013 in AR
Enrollment address
Southeridge Village Nursing and Rehab
400 Southridge Parkway
Herber Springs, AR 72543-8855
Nursing home name
SOUTHRIDGE VILLAGE NURSING AND REHAB
Affiliated entity
ANTHONY & BRYAN ADAMS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Southridge Village Nursing and RehabCCN 045196 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 1, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12292.0 residents per day on average
Chain
Anthony & Bryan Adams38 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D1030130Southridge Village Nursing and Rehab400 Southridge Parkway, Heber Springs, AR 72543Certificate of waiverAug 30, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Shana Rodgers Individual Operational/Managerial ControlAdministrator Jul 1, 2022 100%
Managing Control - Governing BodyGov Body Member/Administrator Jul 1, 2022
Adp of the SNF Jul 1, 2022
Benjamin Cooper Individual Adp of the SNF Jan 1, 2020
Bryan Milburn Adams Individual 5% Or Greater Indirect Ownership InterestVice-President Apr 1, 2014 50%
Corporate OfficerVice President Apr 1, 2014 50%
Franklin Gale Bivins Individual Operational/Managerial ControlMedical Director Aug 28, 2024
Adp of the SNF Aug 28, 2024
Eagle Health Systems Inc Organization, Conway, AR Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2014 100%
Nacole Jack Individual Managing Control - Governing BodyDir of Facility Operations/Gov Body Aug 28, 2024
Adp of the SNF Aug 28, 2024
James B Cooper Individual Adp of the SNF Jan 1, 2020
LTC Systems/RX, LLC Organization, Conway, AR LLC, Consulting firm, For-profit Adp of the SNF Apr 1, 2014
Larry M McGinnis Individual Adp of the SNF Apr 1, 2014
Pharmacy Consults, LLC Organization, Searcy, AR LLC, Consulting firm, For-profit Adp of the SNF Apr 1, 2014
Incite Rehab, LLC Organization, Conway, AR LLC, For-profit Adp of the SNF Apr 1, 2014
Health Care Solutions, LLC Organization, Melbourne, AR LLC, For-profit Adp of the SNF Apr 1, 2019
Rita Pedigo Individual Adp of the SNF Apr 1, 2014
William Mainord Individual Adp of the SNF Apr 1, 2014
John Ellis Individual Corporate OfficerCoo Apr 1, 2014
Adp of the SNF Apr 1, 2014
Reliance Health Care, Inc. Organization, Conway, AR Corporation, For-profit Adp of the SNF Apr 1, 2014
Robert Cooper Individual Adp of the SNF Jan 1, 2020
Tobey Koehler Individual Corporate OfficerCfo Apr 1, 2014
Adp of the SNF Apr 1, 2014
Anthony Brandon Adams Individual 5% Or Greater Indirect Ownership InterestPresident Apr 1, 2014 50%
Corporate OfficerPresident Apr 1, 2014 50%
Darryl Thomas Individual Managing Control - Governing BodyGov Body Member/Dir Fac Ops Apr 1, 2014
Adp of the SNF Apr 1, 2014

Owners & managing parties with NPI records 1

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

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1982020541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SOUTHRIDGE PKWY",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725438855",
            "telephone_number": "501-362-3185",
            "fax_number": "501-362-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SOUTHRIDGE PKWY",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725438855",
            "telephone_number": "501-362-3185",
            "fax_number": "501-362-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HBNC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAGLE HEALTH SYSTEMS, INC.",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-932-0050"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "1042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202100311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHRIDGE VILLAGE NURSING AND REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Heber Springs, AR

Sources for this page

Verify at the official NPI Registry.