Individual provider Active NPI

Lester Trulie Alexander, M.D.

  • Family Medicine Physician
  • Pine Bluff, AR
National Provider Identifier
1306882501
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C5865 Issued in AR
Practice address
4747 Dusty Lake Dr Ste G1
Pine Bluff, AR 71603-9056
Phone
(870) 536-6600
Fax
(870) 534-1519
NPI assigned
Jun 22, 2006
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C5865 AR Primary

Addresses

Primary practice location

4747 Dusty Lake Dr Ste G1
Pine Bluff, AR 71603-9056

Mailing address

4747 Dusty Lake Dr Ste G1
Pine Bluff, AR 71603-9056
Phone (870) 536-6600

Other identifiers 1

IdentifierTypeStateIssuer
50074OtherARBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lesteralexander@jrmc.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110412000398 AR Practitioner - Family Practice 2264616580 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C5865ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Hospital Association, Inc Family Medicine CurrentSince Dec 1, 1983 Accepting new patients
Jefferson Hospital Association, Inc CurrentSince Dec 1, 1983 Accepting new patients

Locations

1600 W 40th Ave
Pine Bluff, AR 71603
Phone (870) 541-7100

1601 W 40th Ave
Ste 301
Pine Bluff, AR 71603
Phone (870) 541-4285

209 N Blake St
Pine Bluff, AR 71601
Phone (870) 536-6600

4747 Dusty Lake Dr
Ste 101
Pine Bluff, AR 71603
Phone (870) 536-6600

4747 Dusty Lake Dr
Ste G1
Pine Bluff, AR 71603
Phone (870) 534-1188

Interoperability endpoints

  • Direct secure messaging: lesteralexander@jrmc.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1306882501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 DUSTY LAKE DR STE G1",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716039056",
            "telephone_number": "870-536-6600",
            "fax_number": "870-534-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 DUSTY LAKE DR STE G1",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716039056",
            "telephone_number": "870-536-6600",
            "fax_number": "870-534-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "LESTER",
        "middle_name": "TRULIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C5865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "50074",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lesteralexander@jrmc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "4747 Dusty Lake Dr Ste G1",
            "city": "Pine Bluff",
            "state": "AR",
            "country_code": "US",
            "postal_code": "716039056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

Verify at the official NPI Registry.