Organization Active NPI

Iti Chito Enterprises Inc

Doing business as Lockesburg Family Clinic

  • Primary Care Clinic/Center
  • De Queen, AR
National Provider Identifier
1134885833
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ITI CHITO ENTERPRISES INC
Doing business as
Lockesburg Family Clinic
Practice address
500 E Collin Raye Dr Ste 2
De Queen, AR 71832-8068
Phone
(870) 289-5192
Fax
(870) 289-4223
NPI assigned
Nov 17, 2021
Organization subpart
Yes
Parent organization
LOCKESBURG FAMILY CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Authorized official

Name
Rusty Lynn Griffin
Title
Owner
Phone
(501) 765-0275

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

500 E Collin Raye Dr Ste 2
De Queen, AR 71832-8068

Mailing address

PO Box 315
Lockesburg, AR 71846-0315
Phone (870) 289-5192

Other names 1

  • Lockesburg Family Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
Iti Chito Enterprises Inc

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1134885833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 315",
            "city": "LOCKESBURG",
            "state": "AR",
            "postal_code": "718460315",
            "telephone_number": "870-289-5192",
            "fax_number": "870-289-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E COLLIN RAYE DR STE 2",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718328068",
            "telephone_number": "870-289-5192",
            "fax_number": "870-289-4223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ITI CHITO ENTERPRISES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOCKESBURG FAMILY CLINIC",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "RUSTY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-765-0275"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lockesburg Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lockesburg Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in De Queen, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.