CRESTPARK WYNNE, LLC
NPI 1518112630
Skilled Nursing Facility in Wynne, AR

Active since November 18, 2008CLIA 04D0718959 · Waiver
3/5
Overall Rating
400 ARKANSAS AVE E, WYNNE, AR 72396(870) 238-7941(870) 238-1989 Get Directions Write a Review

NPPES record last updated: November 18, 2008. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Crestpark Wynne, Llc NPPES

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

CRESTPARK WYNNE, LLC (NPI 1518112630) is a healthcare organization registered as a skilled nursing facility in Wynne, Arkansas and active in the NPI registry since November 2008. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Melisha Dilks, Manager, as its authorized official.

NPPES Registry Identity

NPI1518112630
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameCRESTPARK WYNNE, LLC
Location Address400 ARKANSAS AVE EWynne, AR 72396-3407
Mailing AddressPo Box 1127Wynne, AR 72396-1127 · (870) 238-7941 · Fax (870) 238-1989
Fax(870) 238-1989
Organization SubpartNo
Authorized OfficialMelisha DilksManager · (870) 821-0144
Enumeration DateNovember 18, 2008
NPI 1518112630 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 · 636
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.
400 ARKANSAS AVE E, Wynne, AR 72396

Other Identifiers 3

Other015166AR · Bcbs Provider Number
Medicare OSCAR/certification045166AR
MedicaidPENDINGAR

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 04D0718959

Crestpark Wynne LLC · Wynne, AR
Active · expires Aug 31, 2026
CLIA Number04D0718959
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorKim Dollar
Laboratory Phone(870) 238-7941
Laboratory LocationCrestpark Wynne LLCPO Box 1127, Wynne, AR 72396
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Crestpark Wynne, LLC (CMS certification number 045166), from CMS Care Compare.

Crestpark Wynne, LLC

Nursing home · Wynne, AR
3/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number045166
Certified Beds100 beds37 residents per day on average
Medicare & Medicaid Participant SinceSeptember 1, 1991
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
2/5
Long-Stay Quality
Quality of care delivered to long-term residents.
2/5
Staffing
Based on nursing staff hours relative to resident needs.
2/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
60
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.82 · LPN 1.5 · RN 0.37
4.68 hrs per resident per day
Weekend Nurse Staffing
4.05 hrs per resident per day
Physical Therapist Staffing
0 hrs per resident per day
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
1
Fines
0
Medicare Payment Denials
0
Total Penalties
0
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 3

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

Occupational Therapy Assistant
400 ARKANSAS AVE E
WYNNE, AR 72396
Physical Therapy Assistant
400 ARKANSAS AVE E
WYNNE, AR 72396
Skilled Nursing Facility
400 ARKANSAS AVE E
WYNNE, AR 72396

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 Crestpark Wynne, LLC's NPI number?

The NPI number for Crestpark Wynne, LLC is 1518112630. It was assigned to this organization in the NPPES registry on November 18, 2008.

Where is Crestpark Wynne, LLC located?

Crestpark Wynne, LLC is located at 400 Arkansas Ave E, Wynne, AR 72396. The listed phone number is (870) 238-7941.

What is Crestpark Wynne, LLC's specialty?

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

Does Crestpark Wynne, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D0718959) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Crestpark Wynne, LLC a Medicare-certified nursing home?

Yes. Crestpark Wynne, LLC is a Medicare-certified nursing home with 100 certified beds.

What quality rating does Crestpark Wynne, LLC have?

CMS rates Crestpark Wynne, LLC 3 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for Crestpark Wynne, LLC was last updated on November 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.