SOUTHEAST PART B PRACTICE (SOUTHEAST REHAB LLC.) NPI 1295276970

Nurse Practitioner (Gerontology) in Lake Village, AR

NPI 1295276970 Organization Nurse Practitioner Gerontology

About SOUTHEAST PART B PRACTICE (SOUTHEAST REHAB LLC.)

Southeast Part B Practice (southeast Rehab Llc.) is a provider established in Lake Village, Arkansas specializing in nurse practitioner (gerontology) . The NPI number of Southeast Part B Practice (southeast Rehab Llc.) is 1295276970 and was assigned on March 2017. The practitioner's primary taxonomy code is 363LG0600X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Southeast Part B Practice (southeast Rehab Llc.) operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Southeast Part B Practice. The authorized official of this NPI record is Cathy Waldrop (Administrator)

A nurse practitioner (NP) like Southeast Part B Practice is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

NPI

1295276970

Provider NameSOUTHEAST PART B PRACTICE (SOUTHEAST REHAB LLC.)
Provider Location Address903 BORGOGNONI DR LAKE VILLAGE, AR 71653
Provider Mailing Address903 BORGOGNONI DR LAKE VILLAGE, AR 71653
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameSOUTHEAST PART B PRACTICE
Other Name TypeDoing Business As (3)
Enumeration Date03-15-2017
Last Update Date06-28-2019


Primary Taxonomy

Taxonomy Code363LG0600X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationGerontology

Business Address

SOUTHEAST PART B PRACTICE
903 BORGOGNONI DR
LAKE VILLAGE, AR
ZIP 71653
Phone: (318) 665-9950

Get Directions


Mailing Address

SOUTHEAST PART B PRACTICE
903 BORGOGNONI DR
LAKE VILLAGE, AR
ZIP 71653
Phone: (318) 665-9950



Authorized Official

Authorized Official Name CATHY WALDROP
Authorized Official TitleADMINISTRATOR
Authorized Official Phone(318) 665-9950

Group Taxonomy


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

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1376863597CHICOT OPERATIONS, LLC
Organization
Skilled Nursing Facility903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
(870) 265-5337
1700959905SOUTHEAST REHAB LLC
Organization
Rehabilitation Hospital903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
(318) 665-9950
1942658729SOUTHEAST REHAB LLC
Organization
Family Medicine (Adult Medicine)903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
(870) 265-4333
1700193133CHICOT SNF OPERATIONS LLC
Organization
Skilled Nursing Facility903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
(870) 265-5337
1922677129JSKMF, LLC
Organization
Skilled Nursing Facility903 BORGOGNONI DR
LAKE VILLAGE, AR 71653
(870) 265-5337

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.