Albert Bagsby, RECOVERY ASSISTANT

Key facts

NPI

1114206372

Entity type

Individual (NPI type 1)

Primary specialty

Case Manager/Care Coordinator 171M00000X

Practice address

522 Mill Rd
Clarksville, AR 72830-8511

Phone

(479) 705-1301

NPI assigned

Aug 5, 2011

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 5, 2011.

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312502400000",
    "number": "1114206372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1589",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720181589",
            "telephone_number": "501-315-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 MILL RD",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728308511",
            "telephone_number": "479-705-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGSBY",
        "first_name": "ALBERT",
        "credential": "RECOVERY ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-05",
        "last_updated": "2011-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, AR

• Ashley G Donaldson PA
• Ludwig James Aszod, LPC
• Lisa Atley-King, RECOVERY ASSISTANT
• Brittney Avaritt, LPC
• Clint Allen Bacchus, PT, DPT, OCS
• Ruth Bagsby
• Deeanna Bailey, RECOVERY ASSISTANT
• Hailey Bailey
• Nancy Bailey, CMP
• Christopher Bain, SHIFT SUPERVISORMHPP

All providers in Clarksville, AR · Case Manager/Care Coordinator in Arkansas