NPIMap

Organization Active NPI

Crittenden Memorial Hospital

  • Geriatric Medicine (Internal Medicine) Physician
  • West Memphis, AR
National Provider Identifier
1407890213
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
CRITTENDEN MEMORIAL HOSPITAL
Practice address
304 S Rhodes St
West Memphis, AR 72301-4215
Phone
(870) 733-3867
Fax
(870) 732-7707
NPI assigned
Jun 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Authorized official

Name
Mrs. Jamie Mitchell
Title
Billing Insurance Coordinator
Phone
(870) 733-3867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

304 S Rhodes St
West Memphis, AR 72301-4215

Mailing address

304 S Rhodes St
West Memphis, AR 72301-4215
Phone (870) 733-3867

Other identifiers 1

IdentifierTypeStateIssuer
5F396OtherARBLUE CROSS GROUP

Other names 1

  • Senior Health Clinic Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1407890213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S RHODES ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014215",
            "telephone_number": "870-733-3867",
            "fax_number": "870-732-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S RHODES ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014215",
            "telephone_number": "870-733-3867",
            "fax_number": "870-732-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRITTENDEN MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "BILLING INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "870-733-3867",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP",
            "identifier": "5F396",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senior Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Memphis, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.