NPIMap

Organization Active NPI

Jefferson Pulm CC PA

  • Pulmonary Disease Physician
  • Monticello, AR
National Provider Identifier
1396954228
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
E2334 Issued in AR
Legal business name
JEFFERSON PULM CC PA
Practice address
606 Roberts Drive
Monticello, AR 71655
Phone
(870) 850-6053
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tanya M Simpson
Title
President
Phone
(870) 850-6053

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X E2334 AR Primary

Addresses

Primary practice location

606 Roberts Drive
Monticello, AR 71655

Mailing address

PO Box 7824
Pine Bluff, AR 71611-7824
Phone (870) 850-6053

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396954228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7824",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716117824",
            "telephone_number": "870-850-6053",
            "fax_number": "870-850-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 ROBERTS DRIVE",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "71655",
            "telephone_number": "870-850-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON PULM CC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-850-6053"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AR",
            "license": "E2334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.