NPIMap

Organization Active NPI

St Bernards Physician Clinics, Inc.

  • Internal Medicine Physician
  • Jonesboro, AR
National Provider Identifier
1407577216
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ST BERNARDS PHYSICIAN CLINICS, INC.
Practice address
300 Carson St
Jonesboro, AR 72401-3104
Phone
(870) 932-1198
Fax
(870) 910-7700
NPI assigned
Sep 9, 2022
Last updated
Sep 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Authorized official

Name
John Lieblong
Title
President
Phone
(870) 932-7024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

300 Carson St
Jonesboro, AR 72401-3104

Mailing address

PO Box 1331
Jonesboro, AR 72403-1331
Phone (870) 932-7024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210810001875 AR Part B Supplier - Clinic/Group Practice 7012311269 Receives reassigned benefits from 256 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jonesboro, AR; Lake City, AR; Leachville, AR; Manila, AR; Manilla, AR; Marion, AR; Newport, AR; Osceola, AR…
O20230105000547 MO Part B Supplier - Clinic/Group Practice 7012311269 Receives reassigned benefits from 25 practitioners
3 other NPIs on this enrollment
Practice locations: Jefferson City, MO; Kennett, MO

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1001 W Parker Rd
Jonesboro, AR 72404
Phone (870) 336-1700

303 E Matthews Ave
Ste 100
Jonesboro, AR 72401
Phone (870) 207-2926

Practitioners & affiliated clinicians

Practitioners 72

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 72

NPI Registry JSON

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1407577216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1331",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031331",
            "telephone_number": "870-932-7024",
            "fax_number": "870-930-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CARSON ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013104",
            "telephone_number": "870-932-1198",
            "fax_number": "870-910-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST BERNARDS PHYSICIAN CLINICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "LIEBLONG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-932-7024"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.