Van Buren County Aging Program

Primary specialty

Private VehicleTaxonomy code 347C00000X

License

347C00000X Issued in AR

Legal business name

VAN BUREN COUNTY AGING PROGRAM

Practice address

570 Yellowjacket LN
Clinton, AR 72031-6769

Phone

(501) 745-2244

Fax

(501) 745-5204

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jimmie Leon Kirkendoll

Title

Director

Phone

(501) 745-2244

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275745044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 YELLOWJACKET LN",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "720316769",
            "telephone_number": "501-745-2244",
            "fax_number": "501-745-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 YELLOWJACKET LN",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "720316769",
            "telephone_number": "501-745-2244",
            "fax_number": "501-745-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN BUREN COUNTY AGING PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIRKENDOLL",
        "authorized_official_first_name": "JIMMIE",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "501-745-2244",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "AR",
            "license": "347C00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Private Vehicle in Clinton, AR
• Providers in Clinton, AR by specialty
• Private Vehicle 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.