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MEDI HOME OF PRAIRIE GROVE
NPI 1124109749
Nursing Facility/Intermediate Care Facility in Prairie Grove, AR

Active since October 18, 2006
621 S MOCK ST, PRAIRIE GROVE, AR 72753(479) 846-2169 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Medi Home Of Prairie Grove NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDI HOME OF PRAIRIE GROVE (NPI 1124109749) is a healthcare organization registered as a nursing facility/intermediate care facility in Prairie Grove, Arkansas and active in the NPI registry since October 2006. The organization lists Eddie Martin, Owner, as its authorized official.

NPPES Registry Identity

NPI1124109749
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameSEQUOYAH RESIDENTIAL FACILITY, INC.
Location Address621 S MOCK STPrairie Grove, AR 72753-3146
Mailing AddressPo Box 916Prairie Grove, AR 72753-0916 · (479) 846-2169
Phone(479) 846-2169
Organization SubpartNo
Authorized OfficialEddie MartinOwner · (479) 846-2169
Enumeration DateOctober 18, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1124109749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in AR · 777
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
621 S MOCK ST, Prairie Grove, AR 72753
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Other Names 1

Doing Business AsMedi Home Of Prairie Grove

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JAMES DUNN D.O.
Family Medicine
621 S MOCK ST
PRAIRIE GROVE, AR 72753
Washington County (479) 422-7212
DR JAMES DUNN PLLC
Family Medicine
621 S MOCK ST
PRAIRIE GROVE, AR 72753
Washington County (479) 422-7212
PRAIRIE GROVE HEALTH AND REHABILITATION LLC
Skilled Nursing Facility
621 S MOCK ST
PRAIRIE GROVE, AR 72753
Washington County (479) 846-2169

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sequoyah Residential Facility, Inc.'s NPI number?

The NPI number for Sequoyah Residential Facility, Inc. is 1124109749. It was assigned to this organization in the NPPES registry on October 18, 2006. The provider is doing business as Medi Home Of Prairie Grove.

Where is Sequoyah Residential Facility, Inc. located?

Sequoyah Residential Facility, Inc. is located at 621 S Mock St, Prairie Grove, AR 72753. The listed phone number is (479) 846-2169.

What is Sequoyah Residential Facility, Inc.'s specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

When was this NPI record last updated?

The NPPES record for Sequoyah Residential Facility, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.