Organization Active NPI

State of Arkansas

  • Home Health Agency
  • Jonesboro, AR
National Provider Identifier
1285644310
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
AR3982 Issued in AR
Legal business name
STATE OF ARKANSAS
Practice address
611 East Washington St Suite C
Craighead County Health Unit
Jonesboro, AR 72401-2818
Phone
(870) 933-8734
Fax
(870) 933-7221
NPI assigned
Aug 9, 2006
Organization subpart
Yes
Parent organization
STATE OF ARKANSASAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
Marilyn Evans, RN
Title
Home Health Administrator
Phone
(501) 661-2540

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X AR3982 AR Primary

Addresses

Primary practice location

611 East Washington St Suite C
Craighead County Health Unit
Jonesboro, AR 72401-2818

Mailing address

5800 West 10TH Street
Suite 300
Little Rock, AR 72204-1764
Phone (501) 661-2614

Other identifiers 1

IdentifierTypeStateIssuer
104312514MedicaidAR

Other names 1

  • Craighead County Health Unit Doing business as

National Provider Directory

National Provider Directory
Part of
State of Arkansas

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1285644310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 WEST 10TH STREET",
            "address_2": "SUITE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041764",
            "telephone_number": "501-661-2614",
            "fax_number": "501-661-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 EAST WASHINGTON ST SUITE C",
            "address_2": "CRAIGHEAD COUNTY HEALTH UNIT",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724012818",
            "telephone_number": "870-933-8734",
            "fax_number": "870-933-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF ARKANSAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF ARKANSAS",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "HOME HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "501-661-2540",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AR",
            "license": "AR3982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104312514",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Craighead County Health Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.