Magnolia Pediatric Clinic, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

E2147 Issued in AR

Legal business name

MAGNOLIA PEDIATRIC CLINIC, INC.

Practice address

306 E McNeil
Magnolia, AR 71753-2927

Phone

(870) 234-5171

Fax

(870) 234-0507

NPI assigned

Jul 3, 2006

Organization subpart

No

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

Authorized official

Name

Amy Cross, M.D.NPI 1013917905

Title

Owner/President

Phone

(870) 234-5171

Specialties & licenses 1

Addresses

Other identifiers 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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25257/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Amy W Cross, MD

  • Pediatrics Physician
  • Magnolia, AR
  • NPI 1013917905
  NPD Authorized official

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1396775797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E MCNEIL",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532927",
            "telephone_number": "870-234-5171",
            "fax_number": "870-234-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E MCNEIL",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532927",
            "telephone_number": "870-234-5171",
            "fax_number": "870-234-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PEDIATRIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "870-234-5171",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E2147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140579002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Magnolia Health Center
• Magnolia Health Holdings LLC (Magnolia Health and Rehab)
• Magnolia Healthcare Center LLC
• Magnolia Healthcare Center LLC Group
• Magnolia Healthcare LLC
• Magnolia Regional Health System Inc
• Magnolia Regional Health System Inc
• Magnolia Regional Health System Inc
• Magnolia Regional Health System Inc
• Magnolia Regional Health System Inc

• Pediatrics Physician in Magnolia, AR
• Providers in Magnolia, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.