Chicot Memorial Hospital

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

License

AR4315 Issued in AR

Legal business name

CHICOT MEMORIAL HOSPITAL

Practice address

2729 Hwy 65 and 82 South
Lake Village, AR 71653

Phone

(870) 265-5351

NPI assigned

Dec 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bruce Bennett

Title

Ceo

Phone

(870) 265-5351

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063571107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2729 HWY 65 AND 82 SOUTH",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "71653",
            "telephone_number": "870-265-5351",
            "fax_number": "870-265-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2729 HWY 65 AND 82 SOUTH",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "71653",
            "telephone_number": "870-265-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICOT MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-265-5351"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "AR",
            "license": "AR4315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John P. Burge, MD
• Tammy Carter, CASE MANAGER COORDIN
• Cynthia Rose Charleston, MHPP
• Chicot County Early Childhood Center
• Chicot Memorial ER
• Chicot Memorial Hospital
• Chicot Memorial Hospital Anesthesia
• Chicot Memorial Medical Center
• Chicot Memorial Medical Center
• Chicot Memorial Medical Center

• Critical Access Hospital in Lake Village, AR
• Providers in Lake Village, AR by specialty
• Critical Access Hospital in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.