Pulaski Care Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

04D0465285 Issued in AR

Legal business name

PULASKI CARE INC

Doing business as

medical associates

Practice address

4201 S Mulberry St
Pine Bluff, AR 71603-7016

Phone

(870) 619-1657

Fax

(501) 421-6845

NPI assigned

Oct 13, 2009

Organization subpart

No

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

Authorized official

Name

Jacob K Peters, MDNPI 1841411709

Title

President

Phone

(870) 619-1657

Specialties & licenses 1

Addresses

Other names 1

• medical associates Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacob Kenneth Peters, MD

  • Family Medicine Physician
  • Reedley, CA
  • NPI 1841411709
  NPD (past) Authorized official

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255392000000",
    "number": "1174858831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912B FOUNTAIN AVE",
            "address_2": "SUITE 40",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291502",
            "telephone_number": "870-619-1657",
            "fax_number": "501-421-6845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 S MULBERRY ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037016",
            "telephone_number": "870-619-1657",
            "fax_number": "501-421-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULASKI CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-13",
        "last_updated": "2009-10-13",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-619-1657",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AR",
            "license": "04D0465285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "medical associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Prescott
• Crystal Pridgeon
• Nekita Pridgeon
• Prime Medical Group PLLC
• Nathan Probst, M.D.
• Pulmonary Medicine Clinic PA
• Carla Yvonne Pumphrey, MD
• Quest Middle School of Pine Bluff
• Estelita M Quimosing, M.D.
• Irfan Riaz Qureshi, M.D.

• Clinical Medical Laboratory in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Clinical Medical Laboratory in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.