NPIMap

Organization Active NPI

University of Arkansas for Medical Sciences

Doing business as Kids First Pine Bluff

  • Developmental - Behavioral Pediatrics Physician
  • Pine Bluff, AR
National Provider Identifier
1003982190
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
Legal business name
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Doing business as
Kids First Pine Bluff
Practice address
3450 W 34TH Ave
Pine Bluff, AR 71603
Phone
(501) 686-8000
Fax
(501) 526-6562
NPI assigned
Nov 28, 2006
Last updated
Jun 8, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Authorized official

Name
Amanda D George
Title
Associate VC for Clinical Finance
Phone
(501) 686-6633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X Primary

Addresses

Primary practice location

3450 W 34TH Ave
Pine Bluff, AR 71603

Mailing address

3450 W 34TH Ave
Pine Bluff, AR 71603-5508
Phone (501) 686-8000

Other identifiers 1

IdentifierTypeStateIssuer
136316724MedicaidAR

Other names 1

  • Kids First Pine Bluff Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Raymond Bredfeldt MD111 organizations share this tax ID, including this one
Part of
Raymond Bredfeldt MD

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Interoperability endpoints

  • FHIR API: https://ucsoap.uams.edu/FHIRProxy/HOME/api/FHIR/R4

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528416000000",
    "number": "1003982190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 W 34TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716035508",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 W 34TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71603",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES",
        "enumeration_date": "2006-11-28",
        "last_updated": "2018-06-08",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ASSOCIATE VC FOR CLINICAL FINANCE",
        "authorized_official_telephone_number": "501-686-6633"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136316724",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids First Pine Bluff",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kids First Pine Bluff",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; 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.