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INDIAN ROCK VILLAGE, LLC
NPI 1780633222
Nursing Facility/Intermediate Care Facility in Fairfield Bay, AR

Active since May 10, 2006CLIA 04D0683491 · Waiver
5/5
Overall Rating
265 DAVE CREEK PARKWAY, FAIRFIELD BAY, AR 72088(501) 884-3210(501) 884-6800 Get Directions Write a Review

NPPES record last updated: December 4, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Indian Rock Village, Llc NPPES

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

INDIAN ROCK VILLAGE, LLC (NPI 1780633222) is a healthcare organization registered as a nursing facility/intermediate care facility in Fairfield Bay, Arkansas and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Edward Victor Holman, President, as its authorized official.

NPPES Registry Identity

NPI1780633222
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameINDIAN ROCK VILLAGE, LLC
Location Address265 DAVE CREEK PARKWAYFairfield Bay, AR 72088-3136
Mailing Address265 Dave Creek PkwyFairfield Bay, AR 72088-3106 · (501) 884-3210 · Fax (501) 884-6800
Phone(501) 884-3210
Fax(501) 884-6800
Organization SubpartNo
Authorized OfficialEdward Victor HolmanPresident · (501) 224-0846
Enumeration DateMay 10, 2006
Last NPPES UpdateDecember 4, 2013
✔ NPI 1780633222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in AR · 452
Definition
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.
265 DAVE CREEK PARKWAY, Fairfield Bay, AR 72088
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Other Identifiers 1

Medicare ID-Type Unspecified045153AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.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 04D0683491

Indian Rock Village, LLC · Fairfield Bay, AR
Active · expires Aug 31, 2026
CLIA Number04D0683491
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorHolly Garrigus
Laboratory Phone(501) 884-3210
Laboratory LocationIndian Rock Village, LLC265 Dave Creek Pkwy, Fairfield Bay, AR 72088
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 Indian Rock Village Health Center (CMS certification number 045153), from CMS Care Compare.

Indian Rock Village Health Center

Nursing home · Fairfield Bay, AR
5/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number045153
Certified Beds55 beds41 residents per day on average
Medicare & Medicaid Participant SinceMarch 27, 1990
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.
3/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
19.33
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 2.6 · LPN 0.4 · RN 0.6
3.6 hrs per resident per day
Weekend Nurse Staffing
3.31 hrs per resident per day
Physical Therapist Staffing
0.05 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
55.8%
Registered Nurse Turnover
50%
Administrators Who Have Left
In the past year.
1
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
0
Fines
1 totaling $1,637.52
Medicare Payment Denials
0
Total Penalties
1
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

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 Indian Rock Village, LLC's NPI number?

The NPI number for Indian Rock Village, LLC is 1780633222. It was assigned to this organization in the NPPES registry on May 10, 2006.

Where is Indian Rock Village, LLC located?

Indian Rock Village, LLC is located at 265 Dave Creek Parkway, Fairfield Bay, AR 72088. The listed phone number is (501) 884-3210.

What is Indian Rock Village, LLC's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Indian Rock Village, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D0683491) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Indian Rock Village, LLC a Medicare-certified nursing home?

Yes. Indian Rock Village Health Center is a Medicare-certified nursing home with 55 certified beds.

What quality rating does Indian Rock Village, LLC have?

CMS rates Indian Rock Village Health Center 5 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Indian Rock Village, 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 Indian Rock Village, 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 Indian Rock Village, LLC was last updated on December 4, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.