NPIMap

Organization Active NPI

JP Wornock, MD, PA

Doing business as PrimeCare Medical Clinic

  • Clinic/Center
  • North Little Rock, AR
National Provider Identifier
1407307788
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
BL2016-00512 Issued in AR
Legal business name
JP WORNOCK, MD, PA
Doing business as
PrimeCare Medical Clinic
Practice address
2504 McCain Blvd
Ste 118
North Little Rock, AR 72116-7607
Phone
(501) 812-6655
Fax
(501) 812-6677
NPI assigned
Oct 20, 2016
Organization subpart
Yes
Parent organization
JP WORNOCK, MD, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Authorized official

Name
Emily Harrell
Title
Human Capital Coordinator
Phone
(501) 764-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X BL2016-00512 AR Primary

Addresses

Primary practice location

2504 McCain Blvd
Ste 118
North Little Rock, AR 72116-7607

Mailing address

2504 McCain Blvd
Ste 118
North Little Rock, AR 72116-7607
Phone (501) 812-6655

Other names 1

  • PrimeCare Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
JP Wornock MD PA3 organizations share this tax ID, including this one
Part of
JP Wornock MD PA

Other organizations with this tax ID 2

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

Locations

2504 McCain Blvd
Ste 118
North Little Rock, AR 72116
Phone (501) 812-6655

NPI Registry JSON

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1407307788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 MCCAIN BLVD",
            "address_2": "STE 118",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167607",
            "telephone_number": "501-812-6655",
            "fax_number": "501-812-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 MCCAIN BLVD",
            "address_2": "STE 118",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167607",
            "telephone_number": "501-812-6655",
            "fax_number": "501-812-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JP WORNOCK, MD, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JP WORNOCK, MD, PA",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "HUMAN CAPITAL COORDINATOR",
        "authorized_official_telephone_number": "501-764-1800"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AR",
            "license": "BL2016-00512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PrimeCare Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.