Scarbrough Clinic, Inc.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

P01329 Issued in AR

Legal business name

SCARBROUGH CLINIC, INC.

Practice address

1901 Killough Rd. North
Wynne, AR 72396-2465

Phone

(870) 238-8707

Fax

(870) 238-8711

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Tad Scarbrough, APRN, DCNPI 1144295833

Title

FNP/Chiropractor/President

Phone

(870) 238-8707

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Tad Scarbrough, APRN-C, DC

  • Family Nurse Practitioner
  • Wynne, AR
  • NPI 1144295833
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1386743482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 572",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723960572",
            "telephone_number": "870-238-8707",
            "fax_number": "870-533-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 KILLOUGH RD. NORTH",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723962465",
            "telephone_number": "870-238-8707",
            "fax_number": "870-238-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCARBROUGH CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-12-13",
        "certification_date": "2021-11-29",
        "status": "A",
        "authorized_official_last_name": "SCARBROUGH",
        "authorized_official_first_name": "TAD",
        "authorized_official_title_or_position": "FNP/CHIROPRACTOR/PRESIDENT",
        "authorized_official_telephone_number": "870-238-8707",
        "authorized_official_credential": "APRN, DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1544",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "AR",
            "license": "P01329",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "P01329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE ID #",
            "identifier": "647764",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158844718",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE ID NUMBER",
            "identifier": "19754000040",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID NUMBER",
            "identifier": "7359415",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ID NUMBER",
            "identifier": "3821243",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUECROSSBLUESHIELD",
            "identifier": "5U931",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ebony Danielle Robinson Smith
• Octavia Robinson, LAT, ATC
• Stephen Rohrer, CNP
• Taylor Scott Runsick, PTA
• Angela Saldana
• Tad Scarbrough, APRN-C, DC
• Farley Lynn Schweighart, PT
• Rhoschandra Lakisha Scott
• Carson Sellers
• Joshua Wayne Sharp, OT

• Family Nurse Practitioner in Wynne, AR
• Providers in Wynne, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.