NPIMap

Organization Active NPI

Northeast Arkansas Community Mental Health Center Inc

Doing business as Mid South Health Systems, Inc.

  • Community/Behavioral Health Agency
  • Blytheville, AR
National Provider Identifier
1043461510
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 INC
Doing business as
Mid South Health Systems, Inc.
Practice address
209 S Lockard St
Blytheville, AR 72315-2541
Phone
(870) 763-2139
Fax
(870) 972-4911
NPI assigned
Oct 2, 2008
Last updated
Apr 22, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER INC 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
Carla Jones
Title
Office Manager
Phone
(870) 972-4900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

209 S Lockard St
Blytheville, AR 72315-2541

Mailing address

2707 Browns LN
Jonesboro, AR 72401-7213
Phone (870) 972-4000

Other identifiers 1

IdentifierTypeStateIssuer
172110526MedicaidAR

Other names 1

  • Mid South Health Systems, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040110000206 AR Part B Supplier - Clinic/Group Practice 0244130839 Receives reassigned benefits from 43 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marianna, AR; Pocahontas, AR; Melbourne, AR; Newport, AR; Paragould, AR; Salem, AR; Searcy, AR; Truman, AR…

Other NPIs on the same Medicare enrollment 28

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 28

National Provider Directory

National Provider Directory
Tax ID family
Northeast Arkansas Community Mental Health Center Inc43 organizations share this tax ID, including this one
Part of
Northeast Arkansas Community Mental Health Center Inc

Other organizations with this tax ID 42

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

View all 42

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1043461510",
    "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": "870-972-4000",
            "fax_number": "870-972-4968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S LOCKARD ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152541",
            "telephone_number": "870-763-2139",
            "fax_number": "870-972-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER INC INC",
        "enumeration_date": "2008-10-02",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-972-4900"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172110526",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid South Health Systems, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mid South Health Systems, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blytheville, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.