NPIMap

Individual provider Active NPI

Douglas Maglothin, M.D.

  • Family Medicine Physician
  • Jonesboro, AR
National Provider Identifier
1104887215
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C-5726 Issued in AR
Practice address
1111 Windover Rd
Jonesboro, AR 72401-6159
Phone
(870) 935-5432
Fax
(870) 935-4887
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C-5726 AR Primary

Addresses

Primary practice location

1111 Windover Rd
Jonesboro, AR 72401-6159

Mailing address

1111 Windover Rd
Jonesboro, AR 72401-6159
Phone (870) 935-5432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100324000736 AR Practitioner - Family Practice 8224173885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Arkansas Clinic Charitable Foundation, Inc.Group PAC ID 2961547526, 294 clinicians

Practice addresses (Care Compare)

1111 Windover Rd
Jonesboro, AR 72401-6159
Phone (870) 935-5432

Hospital & facility affiliations

  • Lester Dierksen Memorial Hospice, LLC Hospice, Hot Springs V, AR, CCN 041575
  • Craighead Nursing Center Nursing home, Jonesboro, AR, CCN 045481

Merit-based Incentive Payment System (MIPS)

Final score
75.65 of 100Reported as group
Quality
44.87
Promoting interoperability
100
Improvement activities
40
Cost
73.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C-5726ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Current Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. CurrentSince Feb 1, 2010 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. CurrentSince Feb 1, 2010 Accepting new patients
Northeast Arkansas Clinic, PA Past Accepting new patients

Locations

1111 Windover Rd
Jonesboro, AR 72401
Phone (870) 935-5432

311 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-4150

Interoperability endpoints

  • Direct secure messaging: dmaglothin29515@direct.bmhcc.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Craighead Nursing CenterJonesboro, AR, CCN 045481 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025
Lester Dierksen Memorial Hospice LLCHot Springs, AR, CCN 041575 Hospice Contracted Managing Employee May 1, 2019

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1104887215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 WINDOVER RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016159",
            "telephone_number": "870-935-5432",
            "fax_number": "870-935-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 WINDOVER RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016159",
            "telephone_number": "870-935-5432",
            "fax_number": "870-935-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGLOTHIN",
        "first_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C-5726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.