SOUTHEAST REHABILITATION HOSPITAL
NPI 1942658729
Family Medicine - Adult Medicine in Lake Village, AR

NPI Status: Active since June 02, 2016

Contact Information

903 BORGOGNONI DR
LAKE VILLAGE, AR
ZIP 71653
Phone: (870) 265-4333
Fax: (318) 665-0379

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Group Taxonomy
Authorized Official
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Family Medicine
Adult Medicine

About SOUTHEAST REHABILITATION HOSPITAL

This page provides the complete NPI Profile along with additional information for Southeast Rehabilitation Hospital, a primary care provider established in Lake Village, Arkansas operating as a Family Medicine, focusing in adult medicine . The healthcare provider is registered in the NPI registry with number 1942658729 assigned on June 2016. The practitioner's primary taxonomy code is 207QA0505X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization 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 Rehabilitation Hospital. The authorized official of this NPI record is Cathy M Waldrop (Chairman)

NPI: 1942658729
Provider Legal Name: SOUTHEAST REHAB LLC
Other Organization Name: SOUTHEAST REHABILITATION HOSPITAL
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 903 BORGOGNONI DR LAKE VILLAGE, AR 71653
Location Phone: (870) 265-4333
Location Fax: (318) 665-0379
Mailing Address: 903 BORGOGNONI DR LAKE VILLAGE, AR 71653
Mailing Phone: (318) 665-9950
Mailing Fax: (318) 665-0379
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 06-02-2016
Last Update Date: 06-28-2019
Code Navigator

A primary care provider (PCP) like Southeast Rehabilitation Hospital sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

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: Family Medicine Adult Medicine
Taxonomy Code: 207QA0505X
Type: Allopathic & Osteopathic Physicians
Taxonomy Description: The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	363AM0700X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant Medical
2	363LA2200X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner Adult Health

Group Taxonomy 193400000X MULTIPLE 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.

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: CATHY M WALDROP
Authorized Official Title: CHAIRMAN
Authorized Official Phone: (318) 665-9950

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	9	4	2	6	5	8	7	2	9
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	9	8	2	12	5	16	7	4
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 8 + 2 + 1 + 2 + 5 + 1 + 6 + 7 + 4 + 24 = 71
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 71 = 9									9

The NPI number 1942658729 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.