Center for Pediatric Neuroscience, PLLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

11-16P Issued in AR

Legal business name

CENTER FOR PEDIATRIC NEUROSCIENCE, PLLC

Practice address

2808 Fox Meadow LN
Jonesboro, AR 72404-9346

Phone

(870) 932-4245

NPI assigned

Dec 8, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Job D Caspall, M.B.A.

Title

Business Manager

Phone

(901) 603-9936

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1174826499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 814",
            "city": "WALNUT RIDGE",
            "state": "AR",
            "postal_code": "724760814",
            "telephone_number": "901-603-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 FOX MEADOW LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049346",
            "telephone_number": "870-932-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PEDIATRIC NEUROSCIENCE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "CASPALL",
        "authorized_official_first_name": "JOB",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "901-603-9936",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "AR",
            "license": "11-16P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3583920",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4302608",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00118484",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189059744",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey Catt, APRN
• Merrill Kay Catt, MSP, CCC-SLP
• Caitlyn Caubble
• Mario Cauli, M.D.
• Center for Eating Disorders and Behavioral Wellness PLC
• Central Healthcare
• Charles Cesare Jr., MD
• Catelyn Chadwick
• Cally Chalker
• Cory Dale Chamberlain

• Clinical Neuropsychologist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Clinical Neuropsychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.