St.Joseph's Pet Center LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

ST.JOSEPH'S PET CENTER LLC

Practice address

1 Mercy Lane
Suite 105
Hot Springs, AR 71913

Phone

(877) 223-3988

Fax

(479) 968-4331

NPI assigned

Apr 11, 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

Kerri Couch

Title

Manager

Phone

(479) 968-7930

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083677728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "479-968-7930",
            "fax_number": "479-968-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCY LANE",
            "address_2": "SUITE 105",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "71913",
            "telephone_number": "877-223-3988",
            "fax_number": "479-968-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST.JOSEPH'S PET CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COUCH",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-968-7930"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "5C739",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Allen St. John, M.D.
• Melody D St. John, MD
• St. Joseph's Mercy Clinic, Inc.
• St. Joseph's Mercy Clinic, Inc.
• St. Joseph's Mercy Health Center
• Isabelle Denton Staggs, LPC
• Larry Combs Stamps
• Allison Rae Stanage
• Kayla N Stanage, APRN
• Matthew B. Standfill, CRNA

• Diagnostic Radiology Physician in Hot Springs, AR
• Providers in Hot Springs, AR by specialty
• Diagnostic Radiology Physician 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.