Organization Active NPI

The Surgical Hospital of Jonesboro

  • General Acute Care Hospital
  • Jonesboro, AR
National Provider Identifier
1306897574
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
AR4164 Issued in AR
Legal business name
THE SURGICAL HOSPITAL OF JONESBORO
Practice address
909 Enterprise Dr
Jonesboro, AR 72401-9201
Phone
(870) 336-1100
Fax
(870) 336-1013
NPI assigned
May 13, 2006
Last updated
Dec 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Mr. Nate Miller
Title
Ceo
Phone
(870) 336-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X AR4164 AR Primary

Addresses

Primary practice location

909 Enterprise Dr
Jonesboro, AR 72401-9201

Mailing address

909 Enterprise Dr
Jonesboro, AR 72401-9201
Phone (870) 336-1100

Other identifiers 2

IdentifierTypeStateIssuer
5F081OtherARBCBS PART B PROVIDER #
10145OtherARBCBS PART A

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1306897574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 ENTERPRISE DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724019201",
            "telephone_number": "870-336-1100",
            "fax_number": "870-336-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 ENTERPRISE DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724019201",
            "telephone_number": "870-336-1100",
            "fax_number": "870-336-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SURGICAL HOSPITAL OF JONESBORO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "NATE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-336-1100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AR",
            "license": "AR4164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PART B PROVIDER #",
            "identifier": "5F081",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PART A",
            "identifier": "10145",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 5, 2007; 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.