NPIMap

Organization Active NPI

CB King Uam Campus

  • Developmental Disabilities Clinic/Center
  • McGehee, AR
National Provider Identifier
1043536063
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
License
01923 Issued in AR
Legal business name
CB KING UAM CAMPUS
Practice address
1711 East Ash Street
McGehee, AR 71654
Phone
(870) 222-6589
Fax
(870) 222-3361
NPI assigned
Apr 15, 2010
Last updated
Apr 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Authorized official

Name
Sherry J Gregory
Title
Office Manager
Phone
(870) 222-4544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X 01923 AR Primary

Addresses

Primary practice location

1711 East Ash Street
McGehee, AR 71654

Mailing address

1711 East Ash Street
McGehee, AR 71654
Phone (870) 222-6589

Other identifiers 1

IdentifierTypeStateIssuer
180540724MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
CB King Eudora Center10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271289600000",
    "number": "1043536063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 EAST ASH STREET",
            "city": "MCGEHEE",
            "state": "AR",
            "postal_code": "71654",
            "telephone_number": "870-222-6589",
            "fax_number": "870-222-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 EAST ASH STREET",
            "city": "MCGEHEE",
            "state": "AR",
            "postal_code": "71654",
            "telephone_number": "870-222-6589",
            "fax_number": "870-222-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CB KING UAM CAMPUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-15",
        "last_updated": "2010-04-15",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-222-4544"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "AR",
            "license": "01923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180540724",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McGehee, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; 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.