ST. JOHN'S PLACE OF ARKANSAS
NPI 1326113689
Nursing Facility/Intermediate Care Facility in Fordyce, AR

NPI Status: Active since November 22, 2006

Contact Information

815 BAXTER ST.
FORDYCE, AR
ZIP 71742
Phone: (870) 352-2104

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  • Organization
  • Nursing Facility/Intermediate Care Facil...
  • CLIA Number: 04D1066504
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 03-25-2027

About ST. JOHN'S PLACE OF ARKANSAS

This page provides the complete NPI Profile along with additional information for St. John's Place Of Arkansas, a provider established in Fordyce, Arkansas operating as a Nursing Facility/intermediate Care Facility. The healthcare provider is registered in the NPI registry with number 1326113689 assigned on November 2006. The practitioner's primary taxonomy code is 313M00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Ross Ponthie (Managing Member)

NPI
1326113689
Provider Name
ST. JOHN'S PLACE OF ARKANSAS
Entity Type
Organization
Location Address
815 BAXTER ST. FORDYCE, AR 71742
Location Phone
(870) 352-2104
Mailing Address
PO BOX 1025 FORDYCE, AR 71742
Mailing Phone
(870) 352-2104
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-22-2006
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nursing Facility/Intermediate Care Facility

Taxonomy Code
313M00000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ROSS PONTHIE

Authorized Official Title
MANAGING MEMBER
Authorized Official Phone
(318) 443-8167

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
04D1066504
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
March 26, 2025
Certificate Expiration Date
March 25, 2027
Laboratory Director
AMANDA L. COOK
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to St. John's Place Of Arkansas to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1326113689, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
2
Doubled → 4
Pos 4
6
Unchanged
Pos 5
1
Doubled → 2
Pos 6
1
Unchanged
Pos 7
3
Doubled → 6
Pos 8
6
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 1 → 2 3 → 6 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 4 + 6 + 2 + 1 + 6 + 6 + 1 + 6 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1326113689.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1326113689, enumerated as an "organization" on November 22, 2006.

The provider is located at 815 BAXTER ST. FORDYCE, AR 71742 and the phone number is (870) 352-2104.

Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.