James T. Meredith Jr MD PA

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

MC0977 Issued in AR

Legal business name

JAMES T. MEREDITH JR MD PA

Practice address

921 Holiday Dr
Forrest City, AR 72335-9183

Phone

(870) 633-4711

Fax

(870) 633-4850

NPI assigned

Mar 16, 2006

Organization subpart

No

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

Authorized official

Name

James Therold Meredith Jr., MDNPI 1639173420

Title

Owner

Phone

(870) 633-4711

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 3

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

• James Therold Meredith Jr., M.D.

  • Family Medicine Physician
  • Forrest City, AR
  • NPI 1639173420
  Medicare reassignment Care Compare group NPD Authorized official
• Tracy Jill Jones, APRN

  • Family Nurse Practitioner
  • Forrest City, AR
  • NPI 1639398571
  Medicare reassignment Care Compare group
• Madeline Kennedy Herrington, APRN-CNP

  • Family Nurse Practitioner
  • Forrest City, AR
  • NPI 1841804945
  Medicare reassignment NPD

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1164491767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 HOLIDAY DR",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723359183",
            "telephone_number": "870-633-4711",
            "fax_number": "870-633-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 HOLIDAY DR",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723359183",
            "telephone_number": "870-633-4711",
            "fax_number": "870-633-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES T. MEREDITH JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-16",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "MEREDITH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "THEROLD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-633-4711",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "AR",
            "license": "MC0977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106020002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG5130",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Careasha Jackson, PLMSW
• Donnie Jackson, RN
• Josephine Furdge Jackson, APRN
• Marvin L Jackson, MHPP
• James Franks Family Medicine
• Bethany Jeffers, RN
• Irma N Jenkins, CRNA
• Byron Edney Johnson, PHARMD
• Jimmy T Johnson
• Nathalie Johnson, BS MHPP

• Preferred Provider Organization in Forrest City, AR
• Providers in Forrest City, AR by specialty
• Preferred Provider Organization in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.