NPIMap

Organization Active NPI

Northeast Arkansas Clinic, PA

Doing business as NEA Clinic

  • Multi-Specialty Clinic/Center
  • Jonesboro, AR
National Provider Identifier
1376517177
Registry record updated Apr 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
NORTHEAST ARKANSAS CLINIC, PA
Doing business as
NEA Clinic
Practice address
1835 Grant Ave.
Jonesboro, AR 72401
Phone
(870) 934-5101
Fax
(870) 932-3608
NPI assigned
Feb 16, 2006
Last updated
Apr 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2010

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

Authorized official

Name
Errol Scot Davis
Title
Cfo
Phone
(870) 934-5803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

1835 Grant Ave.
Jonesboro, AR 72401

Mailing address

P.O. Box 1960
Jonesboro, AR 72403-1960
Phone (870) 934-5101

Other identifiers 1

IdentifierTypeStateIssuer
139864002MedicaidAR

Other names 1

  • NEA Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

1835 Grant Ave
Jonesboro, AR 72401
Phone (870) 934-5102

Practitioners & affiliated clinicians

Practitioners 150

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.

View all 150

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270425600000",
    "number": "1376517177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1960",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031960",
            "telephone_number": "870-934-5101",
            "fax_number": "870-932-3608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 GRANT AVE.",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-934-5101",
            "fax_number": "870-932-3608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ARKANSAS CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-16",
        "last_updated": "2010-04-05",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ERROL",
        "authorized_official_middle_name": "SCOT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-934-5803"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139864002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEA Clinic",
            "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 Apr 5, 2010; 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.