ST BERNARD COMMUNITY HOSPITAL CORPORATION (NPI# 1538179635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538179635 |
| Entity Type | Organization |
| Organization Name | ST BERNARD COMMUNITY HOSPITAL CORPORATION |
| Other Organization Name | CROSSRIDGE COMMUNITY HOSPITAL |
| Practice Address |
732 E Eldridge St Wynne AR 72396 |
| Mailing Address |
Po Box 590 Wynne AR 72396-0590 |
| Practice Telephone | 8702383300 |
| Practice Fax Number | 8702387432 |
| Mailing Telephone | 8702383300 |
| Mailing Fax Number | 8702387432 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-09-17 |
| Authorized Official Name | MR. BRYAN MATTES (ASSOCIATE ADMINISTRATOR) |
| Authorized Official Telephone | 8702383300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | AR3891 | AR | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUE CROSS HOME HEALTH | 17048 | 01 |
| AR | 142758514 | 05 | |
| AR | 143518753 | 05 | |
| AR | 145227754 | 05 |
| Other Name | Type Code |
|---|---|
| CrossRidge Community Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982615589 | St Bernard Community Hospital Corporation | General Acute Care Hospital | 310 Falls Blvd S, Wynne, AR 72396-3013 | 2006-08-10 |
| 1114937174 | St Bernard Community Hospital Corporation | General Acute Care Hospital | 310 Falls Blvd S, Wynne, AR 72396-3013 | 2006-08-09 |
| 1962410183 | St Bernard Community Hospital Corporation | General Acute Care Hospital | 310 Falls Blvd S, Wynne, AR 72396-3013 | 2006-08-03 |
| Street Address |
732 E ELDRIDGE ST |
| City | WYNNE |
| State | AR |
| Zip Code | 72396 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962918813 | David Makool | Occupational Therapy Assistant | 2000 Gogbill Road, Wynne, AR 72396 | 2017-12-14 |
| 1912425554 | Barbara Ann Burgess | Case Manager/Care Coordinator | 661 Addison, Wynne, AR 72396 | 2017-09-05 |
| 1518481308 | Tyler Leigh Shumard | Physical Therapy Assistant | 128 County Road 145, Wynne, AR 72396 | 2017-08-02 |
| 1588957476 | Northeast Arkansas Community Mental Health Center | Counselor | 661 Addison Dr., Wynne, AR 72396 | 2011-05-25 |
| 1417106493 | Katherine Danielle Calhoun | Dietitian, Registered | 1013 Bridges Ave East, Wynne, AR 72396 | 2008-09-15 |
| 1053531319 | George Scott Puryear, Dds, Pa | Dentist | 715 East Eldrdige Avenue, Wynne, AR 72396 | 2007-04-27 |
| 1730245465 | Marilyn J Cullum | Counselor | 1742 Falls Blvd. Suite 5, The Logan Center, Wynne, AR 72396 | 2006-12-28 |
| 1770655185 | Robert Walton Bassham | Dentist | 669 Addison Drive, Wynne, AR 72396 | 2006-11-14 |
| 1073683827 | George Scott Puryear Jr. | Dentist | 715 E. Eldridge Ave, Wynne, AR 72396 | 2006-11-09 |
| 1194809517 | Richard Keeter Toland | Dentist | 2100 North Killough, Wynne, AR 72396 | 2006-10-24 |
| Find all providers in zip 72396 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255341392 | State of Arkansas | Home Health | 704 Canal Street, Cross County Health Unit, Wynne, AR 72396-3042 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528670130 | Home Health Care Agency of Arkansas, LLC | Home Health | 1200 John Barrow Road Suite #111, Little Rock, AR 72205-6528 | 2020-08-17 |
| 1316557127 | Voices of Healthcare | Home Health | 3700 S Caraway Rd Apt K07, Jonesboro, AR 72404-9537 | 2020-08-06 |
| 1093325334 | Clararose Home Care | Home Health | 802 Parrish St, Jacksonville, AR 72076-2720 | 2020-08-02 |
| 1447876024 | Jabez Community Resource Center | Home Health | 2910 Dickson St, West Memphis, AR 72301-3638 | 2020-06-19 |
| 1912521295 | Thrive Pediatric Nursing Inc | Home Health | 808 Reservoir Rd Ste A, Little Rock, AR 72227-5729 | 2020-06-03 |
| 1124651153 | Lareco Walker Sr. | Home Health | 1907 Hwy 5 N Apt 1010, Benton, AR 72019-6733 | 2020-02-18 |
| 1518500495 | Quality Senior Care, Inc. | Home Health | 17724 I 30 Ste 5, Benton, AR 72019-2961 | 2019-10-23 |
| 1659912376 | Diamond Personal Care, Ll | Home Health | 25 Macarthur Dr, Conway, AR 72032-4510 | 2019-10-03 |
| 1427607837 | Leyia Staffing Agency LLC | Home Health | 309 N 6th St Ste 3, West Memphis, AR 72301-3294 | 2019-09-09 |
| 1497317820 | 1 To 1 Home Care Services | Home Health | 1200 Westpark Dr Ste 202, Little Rock, AR 72204-2487 | 2019-07-06 |
| 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.