Children'S Clinic, P.a.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

CHILDREN'S CLINIC, P.A.

Practice address

1420 W 43Rd Ave
Pine Bluff, AR 71603-7010

Phone

(870) 534-6210

Fax

(870) 534-8620

NPI assigned

Apr 12, 2006

Organization subpart

No

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

Authorized official

Name

Horace L Green, M.D.

Title

Physician

Phone

(870) 534-6210

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255395950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 W 43RD AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037010",
            "telephone_number": "870-534-6210",
            "fax_number": "870-534-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W 43RD AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037010",
            "telephone_number": "870-534-6210",
            "fax_number": "870-534-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "HORACE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "870-534-6210",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BLUE CROSS",
            "identifier": "56703",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashton Cheatham, PHARM. D.
• Daniel Marion Cheatham, APRN
• Sree Chellappan, MD
• Chelsea Briggs
• Raven Cherry, RN
• Stephen Christian
• City 2 City Marketing & Distribution
• Charles A Clark, MD
• Debra Doublet Clark, PA-C
• Derwin Clark

• Pediatric Adolescent Medicine Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Pediatric Adolescent Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.