NPIMap

Organization Active NPI

Psychiatric Clinic of Hot Springs PA

  • Psychiatry Physician
  • Hot Springs, AR
National Provider Identifier
1124105416
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C5421 Issued in AR
Legal business name
PSYCHIATRIC CLINIC OF HOT SPRINGS PA
Practice address
300 Werner St
Hot Springs, AR 71913-6406
Phone
(501) 262-5614
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2012

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

Authorized official

Name
Dr. Charles S Lane III, MD
Title
President
Phone
(501) 262-5614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X C5421 AR Primary

Addresses

Primary practice location

300 Werner St
Hot Springs, AR 71913-6406

Mailing address

PO Box 6005
Hot Springs, AR 71902-6005
Phone (501) 262-5614

Other identifiers 1

IdentifierTypeStateIssuer
121301002MedicaidAR

National Provider Directory

National Provider Directory

Locations

1401 Malvern Ave
Ste 260
Hot Springs National Park, AR 71901
Phone (501) 624-4490

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1124105416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6005",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719026005",
            "telephone_number": "501-262-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WERNER ST",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136406",
            "telephone_number": "501-262-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC CLINIC OF HOT SPRINGS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-262-5614",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "C5421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121301002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.