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SOUTHEAST PART B PRACTICE
NPI 1295276970
Nurse Practitioner - Gerontology in Lake Village, AR

Active since March 15, 2017
903 BORGOGNONI DR, LAKE VILLAGE, AR 71653(318) 665-9950 Get Directions Write a Review

NPPES record last updated: June 28, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southeast Part B Practice NPPES

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

SOUTHEAST PART B PRACTICE (NPI 1295276970) is a healthcare organization registered as a gerontology in Lake Village, Arkansas and active in the NPI registry since March 2017. The organization lists Cathy Waldrop, Administrator, as its authorized official.

NPPES Registry Identity

NPI1295276970
Entity TypeOrganization
Primary Taxonomy363LG0600X
Legal Business NameSOUTHEAST REHAB LLC.
Location Address903 BORGOGNONI DRLake Village, AR 71653-1623
Mailing Address903 Borgognoni DrLake Village, AR 71653-1623 · (318) 665-9950
Phone(318) 665-9950
Organization SubpartNo
Authorized OfficialCathy WaldropAdministrator · (318) 665-9950
Enumeration DateMarch 15, 2017
Last NPPES UpdateJune 28, 2019
✔ NPI 1295276970 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
903 BORGOGNONI DR, Lake Village, AR 71653
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Other Names 1

Doing Business AsSoutheast Part B Practice

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

CHICOT OPERATIONS, LLC
Skilled Nursing Facility
903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5337
LAKE VILLAGE OPERATIONS LLC
Skilled Nursing Facility
903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5337
CHICOT SNF OPERATIONS LLC
Skilled Nursing Facility
903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5337
JSKMF, LLC
Skilled Nursing Facility
903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5337
SOUTHEAST REHAB LLC
Family Medicine (Adult Medicine)
903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
Chicot County (870) 265-4333

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 Southeast Rehab LLC.'s NPI number?

The NPI number for Southeast Rehab LLC. is 1295276970. It was assigned to this organization in the NPPES registry on March 15, 2017. The provider is doing business as Southeast Part B Practice.

Where is Southeast Rehab LLC. located?

Southeast Rehab LLC. is located at 903 Borgognoni Dr, Lake Village, AR 71653. The listed phone number is (318) 665-9950.

What is Southeast Rehab LLC.'s specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

When was this NPI record last updated?

The NPPES record for Southeast Rehab LLC. was last updated on June 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.