SOUTHERN CAREGIVERS, LTD (NPI# 1396396420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396396420 |
| Entity Type | Organization |
| Organization Name | SOUTHERN CAREGIVERS, LTD |
| Practice Address |
710 Sue Magnolia AR 71753-2127 |
| Practice Telephone | 8709044277 |
| Mailing Telephone | 8709044277 |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-09-20 |
| Authorized Official Name | BLAKE WATSON (OWNER) |
| Authorized Official Telephone | 8709044277 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| N | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers | ||
| N | 376J00000X | Homemaker | Nursing Service Related Providers | ||
| N | 385H00000X | Respite Care | Respite Care Facility | ||
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 233111797 | 05 | |
| AR | 233113757 | 05 | |
| AR | 231548732 | 05 |
| Street Address |
710 SUE |
| City | MAGNOLIA |
| State | AR |
| Zip Code | 71753-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851939862 | Kylie Nokes | Occupational Therapy Assistant | 1403 High School Drive, Magnolia, AR 71753 | 2019-12-20 |
| 1225510266 | Douglas Palmer | Specialist/Technologist | 100 E University St, Magnolia, AR 71753 | 2018-09-06 |
| 1568940781 | Alyssa Scholl | Specialist/Technologist | Msc 8800, Magnolia, AR 71753 | 2018-07-31 |
| 1881141950 | Yuichi Takizawa | Specialist/Technologist | 2212 Lacari Dr., Fox Creek Apt #a1, Magnolia, AR 71753 | 2016-09-07 |
| 1609322981 | Stephen Baldwin Jr. | Specialist/Technologist | 100 E University Msc 9202, Magnolia, AR 71753 | 2016-08-28 |
| 1760830038 | Deborah Ellis | Developmental Therapist | 301 West Calhoun, Magnolia, ARKANSAS 71753 | 2016-05-27 |
| 1053720144 | Alaina Atkinson-murphy | Counselor | 1705 E North St, Magnolia, AR 71753 | 2014-08-04 |
| 1467701250 | Charles P Story | Physical Therapy Assistant | 191 E Columbia # 25, Magnolia, AR 71753 | 2012-09-07 |
| 1043565542 | Magnolia Surgery Center, LLC | Clinic/Center | 25 Columbia Road 47, Magnolia, AR 71753 | 2012-07-20 |
| 1427288232 | Emily Loftin | Physical Therapy Assistant | 310 West Calhoun Road, Magnolia, AR 71753 | 2009-07-15 |
| Find all providers in zip 71753 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748573 | Tammy Dawn Mckeehan | Technician | 29888 Highway 84, Malvern, AR 72104-8538 | 2020-10-20 |
| 1346855038 | Kimberly Ferguson | Technician | 4103 Reynolds Park Road, Paragould, AR 72450-2118 | 2020-09-10 |
| 1871104182 | Michele Lynn Jones | Technician | 2905 Stonegate Dr, Paragould, AR 72450 | 2020-08-11 |
| 1518584077 | Robert Ray Davis | Technician | 1519 Mulberry Salem Rd, Benton, AR 72019-8253 | 2020-07-01 |
| 1477179422 | Bianca Smith | Technician | 136 Pecan St, Marked Tree, AR 72365-1926 | 2020-06-24 |
| 1508482001 | Mid-south Personal Care Agency, LLC | Technician | 83 Harvard Rd, Marion, AR 72364-9738 | 2020-06-19 |
| 1568098036 | Lynn Hodge | Technician | 18803 Strawberry Plant Rd, Fayetteville, AR 72704-8587 | 2020-03-17 |
| 1225663073 | Martha Hall | Technician | 144 Morningside Drive, Marion, AR 72364 | 2020-03-11 |
| 1053945352 | Robert Leroy Johnson | Technician | 29 Tucker Rd, Hardy, AR 72542-9115 | 2020-02-25 |
| 1700410263 | Jessica Smith | Technician | 4112 Sugar Maple Ln, Little Rock, AR 72223-2161 | 2020-02-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.