Individual provider Active NPI

Adrienne Estelle Loftis, D.O.

  • Obstetrics & Gynecology Physician
  • Jonesboro, AR
National Provider Identifier
1184885253
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
E-10821 Issued in AR
Practice address
416 E Washington Ave
Jonesboro, AR 72401-3108
Phone
(870) 333-5476
Fax
(870) 333-5475
NPI assigned
Jun 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT012683 PA
Obstetrics & Gynecology Physician 207V00000X E-10821 AR Primary

Addresses

Primary practice location

416 E Washington Ave
Jonesboro, AR 72401-3108

Mailing address

PO Box 497
Augusta, AR 72006-0497
Phone (870) 347-2534

Other practice location 1

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-6006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170929002412 AR Practitioner - Obstetrics/Gynecology 5991952681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Oklahoma State University College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Institute of TechnologyGroup PAC ID 3779496039, 42 clinicians

Practice addresses (Care Compare)

333 Red Wolf Blvd
Suite B
Jonesboro, AR 72405-9739
Phone (870) 933-2054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OT012683PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
New York Institute of Technology CurrentSince Oct 1, 2020 Accepting new patients
New York Institute of Technology PastSince Oct 1, 2020 Accepting new patients
Doctors Health Group, Inc PastSince May 23, 2018 Accepting new patients

Locations

333 Red Wolf Blvd
Ste B
Jonesboro, AR 72405
Phone (870) 933-2054

333 Red Wolf Blvd
#B
Jonesboro, AR 72405
Phone (870) 680-8809

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBCCCA/Endpoint/CBCCCA

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1184885253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497",
            "city": "AUGUSTA",
            "state": "AR",
            "postal_code": "720060497",
            "telephone_number": "870-347-2534",
            "fax_number": "870-347-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E WASHINGTON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013108",
            "telephone_number": "870-333-5476",
            "fax_number": "870-333-5475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-6006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOFTIS",
        "first_name": "ADRIENNE",
        "middle_name": "ESTELLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT012683",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "E-10821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.