ST.JOHN'S PLACE
NPI 1154541878
Skilled Nursing Facility in Fordyce, AR

Active since April 26, 2007CLIA 04D1066504 · Waiver
1400 HIGHWAY 79 167 BYP, FORDYCE, AR 71742(870) 352-2104(870) 352-8969 Get Directions Write a Review

NPPES record last updated: February 20, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 20, 2023, Jul 28, 2021, Aug 22, 2020 (3 updates tracked since 2020).

About St.john's Place NPPES

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

ST.JOHN'S PLACE (NPI 1154541878) is a healthcare organization registered as a skilled nursing facility in Fordyce, Arkansas and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through March 25, 2027 and lists John Ponthie, Member, as its authorized official.

NPPES Registry Identity

NPI1154541878
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameST JOHN'S PLACE OF ARKANSAS, LLC
Location Address1400 HIGHWAY 79 167 BYPFordyce, AR 71742-1728
Mailing Address1400 Highway 79 167 BypFordyce, AR 71742-1728 · (870) 352-2104 · Fax (870) 352-8969
Fax(870) 352-8969
Organization SubpartNo
Authorized OfficialJohn PonthieMember · (318) 216-3316
Enumeration DateApril 26, 2007
Last NPPES UpdateFebruary 20, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 20, 2023
NPI 1154541878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in AR · 832
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
1400 HIGHWAY 79 167 BYP, Fordyce, AR 71742

Other Names 1

Doing Business AsSt.john's Place

Other Identifiers 1

Medicaid162887311AR

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D1066504

St John's Place Of Arkansas LLC · Fordyce, AR
Active · expires Mar 25, 2027
CLIA Number04D1066504
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateMarch 26, 2025
Certificate Expiration DateMarch 25, 2027
Laboratory DirectorAmanda L. Cook
Laboratory Phone(870) 352-2104
Laboratory LocationSt John's Place Of Arkansas LLC1400 Hwy 79-167 By-Pass, Fordyce, AR 71742
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 St John's Place Of Arkansas, LLC's NPI number?

The NPI number for St John's Place Of Arkansas, LLC is 1154541878. It was assigned to this organization in the NPPES registry on April 26, 2007. The provider is doing business as St.John's Place.

Where is St John's Place Of Arkansas, LLC located?

St John's Place Of Arkansas, LLC is located at 1400 Highway 79 167 Byp, Fordyce, AR 71742. The listed phone number is (870) 352-2104.

What is St John's Place Of Arkansas, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does St John's Place Of Arkansas, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D1066504) is associated with this NPI, valid through March 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does St John's Place Of Arkansas, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 5 other insurers list St John's Place Of Arkansas, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for St John's Place Of Arkansas, LLC was last updated on February 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.