State of Arkansas
NPI 1417052895ActiveOrganization· Skilled Nursing Facility· Fayetteville, AR
Skilled Nursing Facility in Fayetteville, Arkansas, registered in NPPES in September 2006. The authorized official on file is Phillip Cappiello, Administrator. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1417052895 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 13, 2006 |
| Last updated in NPPES | May 17, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | 803 | AR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (AR) |
|---|
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