NPIMap

Organization Active NPI

Arkansas Department of Health

Doing business as ADH Southeast Region EPSDT

  • Public Health or Welfare Agency
  • Lake Village, AR
National Provider Identifier
1205154044
Registry record updated May 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
ARKANSAS DEPARTMENT OF HEALTH
Doing business as
ADH Southeast Region EPSDT
Practice address
1742 Hwy 65 and 82 South
Lake Village, AR 71653
Phone
(870) 265-2236
Fax
(870) 265-8001
NPI assigned
May 4, 2010
Last updated
May 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2010

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

Authorized official

Name
Ms. Terri S Wright
Title
Agency Program Coordinator
Phone
(501) 661-2859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

1742 Hwy 65 and 82 South
Lake Village, AR 71653

Mailing address

4815 W Markham St
Slot 40
Little Rock, AR 72205-3866
Phone (501) 661-2859

Other identifiers 1

IdentifierTypeStateIssuer
181187002MedicaidAR

Other names 1

  • ADH Southeast Region EPSDT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Department of Health and Human Services35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Locations

1742 S Highway 65 82
Lake Village, AR 71653
Phone (870) 265-2236

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272931200000",
    "number": "1205154044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 W MARKHAM ST",
            "address_2": "SLOT 40",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053866",
            "telephone_number": "501-661-2859",
            "fax_number": "501-661-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 HWY 65 AND 82 SOUTH",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "71653",
            "telephone_number": "870-265-2236",
            "fax_number": "870-265-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-04",
        "last_updated": "2010-05-04",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AGENCY PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "501-661-2859",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181187002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADH Southeast Region EPSDT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Village, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; 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.