NPIMap

Organization Active NPI

Doctors Health Group, Inc

Doing business as Acute Care Center

  • Family Medicine Physician
  • Jonesboro, AR
National Provider Identifier
1225091176
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DOCTORS HEALTH GROUP, INC
Doing business as
Acute Care Center
Practice address
333 Red Wolf Blvd
Jonesboro, AR 72405-9739
Phone
(870) 972-8181
Fax
(870) 933-1824
NPI assigned
Apr 11, 2006
Last updated
Nov 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Authorized official

Name
Mr. John Lieblong
Title
VP Physician Services
Phone
(870) 932-7024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

333 Red Wolf Blvd
Jonesboro, AR 72405-9739

Mailing address

PO Box 1331
Jonesboro, AR 72403-1331
Phone (870) 972-8181

Other identifiers 1

IdentifierTypeStateIssuer
150133002MedicaidAR

Other names 1

  • Acute Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000461 AR Part B Supplier - Clinic/Group Practice 7315844586 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
Practice locations: Piggott, AR

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Paragould Doctors' ClinicParagould, AR, CCN 043822 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 14, 1996
Piggott Family Medical ClinicPiggott, AR, CCN 043834 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 2, 2013

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 5

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": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1225091176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1331",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031331",
            "telephone_number": "870-972-8181",
            "fax_number": "870-933-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 RED WOLF BLVD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724059739",
            "telephone_number": "870-972-8181",
            "fax_number": "870-933-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS HEALTH GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "LIEBLONG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "870-932-7024",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150133002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Acute Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Acute Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.