NPIMap

Organization Active NPI

Red River Health, LLC

  • Multi-Specialty Clinic/Center
  • Jonesboro, AR
National Provider Identifier
1346923273
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
RED RIVER HEALTH, LLC
Practice address
2908 S Caraway Rd Ste a
Jonesboro, AR 72401-7345
Phone
(870) 336-2195
Fax
(870) 336-2197
NPI assigned
Aug 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Robin Brule
Title
Cfo
Phone
(903) 792-7435

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

2908 S Caraway Rd Ste a
Jonesboro, AR 72401-7345

Mailing address

1550 Moores LN
Texarkana, TX 75503-4657
Phone (903) 792-7435

Other names 1

  • Red River Health of Jonesboro Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230926004033 AR Part B Supplier - Clinic/Group Practice 7416320783 Receives reassigned benefits from 7 practitioners
Practice locations: Jonesboro, AR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Red River Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1550 Moores Ln
Texarkana, TX 75503
Phone (903) 792-7435

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1346923273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034657",
            "telephone_number": "903-792-7435",
            "fax_number": "903-792-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 S CARAWAY RD STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017345",
            "telephone_number": "870-336-2195",
            "fax_number": "870-336-2197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED RIVER HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "BRULE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "903-792-7435"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red River Health of Jonesboro",
            "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 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.