HERITAGE SQUARE HEALTHCARE CENTER
NPI 1205319340
Skilled Nursing Facility in Blytheville, AR

Active since September 14, 2018CLIA 04D1064024 · Waiver
710 N RUDDLE RD, BLYTHEVILLE, AR 72315(870) 763-3654(870) 762-1172 Get Directions Write a Review

NPPES record last updated: October 4, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 4, 2024, Sep 18, 2018, Sep 14, 2018 (3 updates tracked since 2018).

About Heritage Square Healthcare Center NPPES

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

HERITAGE SQUARE HEALTHCARE CENTER (NPI 1205319340) is a healthcare organization registered as a skilled nursing facility in Blytheville, Arkansas and active in the NPI registry since September 2018. The organization holds a CLIA Waiver certificate valid through January 25, 2027 and lists Boyd Wright, Ceo, as its authorized official.

NPPES Registry Identity

NPI1205319340
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameCHC HERITAGE SQUARE NURSING CENTER, LLC
Location Address710 N RUDDLE RDBlytheville, AR 72315-2137
Mailing Address305 Highway 64 E Ste DAugusta, AR 72006-5158 · (870) 347-0001
Fax(870) 762-1172
Organization SubpartNo
Authorized OfficialBoyd WrightCeo · (870) 347-0001
Enumeration DateSeptember 14, 2018
Last NPPES UpdateOctober 4, 20243 updates tracked since enumeration
NPPES CertifiedOctober 4, 2024
NPI 1205319340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
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.
710 N RUDDLE RD, Blytheville, AR 72315

Other Names 1

Doing Business AsHeritage Square Healthcare Center

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 04D1064024

Heritage Square Healthcare Center · Blytheville, AR
Active · expires Jan 25, 2027
CLIA Number04D1064024
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJanuary 26, 2025
Certificate Expiration DateJanuary 25, 2027
Laboratory DirectorPhilander Smith
Laboratory Phone(870) 763-3654
Laboratory LocationHeritage Square Healthcare Center710 North Ruddle Road, Blytheville, AR 72315
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Skilled Nursing Facility
710 N RUDDLE RD
BLYTHEVILLE, AR 72315

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 Chc Heritage Square Nursing Center, LLC's NPI number?

The NPI number for Chc Heritage Square Nursing Center, LLC is 1205319340. It was assigned to this organization in the NPPES registry on September 14, 2018. The provider is doing business as Heritage Square Healthcare Center.

Where is Chc Heritage Square Nursing Center, LLC located?

Chc Heritage Square Nursing Center, LLC is located at 710 N Ruddle Rd, Blytheville, AR 72315. The listed phone number is (870) 763-3654.

What is Chc Heritage Square Nursing Center, LLC's specialty?

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

Does Chc Heritage Square Nursing Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D1064024) is associated with this NPI, valid through January 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Chc Heritage Square Nursing Center, 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 Chc Heritage Square Nursing Center, 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 Chc Heritage Square Nursing Center, LLC was last updated on October 4, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.