NPIMap

Organization Active NPI

Northeast Arkansas Community Mental Health Center

  • Community/Behavioral Health Agency
  • Corning, AR
National Provider Identifier
1003109232
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER
Practice address
1500 W Main St
Corning, AR 72422-1932
Phone
(870) 573-3080
Fax
(870) 972-4911
NPI assigned
May 20, 2011
Organization subpart
Yes
Parent organization
NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donnie Lyerly
Title
Credentialing
Phone
(870) 972-4939

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1500 W Main St
Corning, AR 72422-1932

Mailing address

2707 Browns LN
Jonesboro, AR 72401-7213
Phone (870) 972-4939

Other identifiers 1

IdentifierTypeStateIssuer
184176767MedicaidAR

Other names 1

  • MidSouth Health Systems Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Arkansas Community Mental Health Center43 organizations share this tax ID, including this one
Part of
Northeast Arkansas Community Mental Health Center

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Locations

1500 W Main St
Corning, AR 72422
Phone (870) 573-3080

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1003109232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 BROWNS LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017213",
            "telephone_number": "870-972-4939",
            "fax_number": "870-972-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W MAIN ST",
            "city": "CORNING",
            "state": "AR",
            "postal_code": "724221932",
            "telephone_number": "870-573-3080",
            "fax_number": "870-972-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER INC",
        "enumeration_date": "2011-05-20",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "LYERLY",
        "authorized_official_first_name": "DONNIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "870-972-4939"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184176767",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MidSouth Health Systems",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MidSouth Health Systems",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corning, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.