NPIMap

Organization Active NPI

South Arkansas Physician Services LLC

  • Family Medicine Physician
  • El Dorado, AR
National Provider Identifier
1427018704
Registry record updated Mar 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTH ARKANSAS PHYSICIAN SERVICES LLC
Practice address
700 W Grove St
El Dorado, AR 71730-4416
Phone
(870) 863-2000
NPI assigned
Mar 23, 2006
Last updated
Mar 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2022

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

Authorized official

Name
Jennifer L Jackson
Title
Sr. Director Provider Enrollment
Phone
(877) 892-9815

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Nurse Practitioner 363L00000X

Addresses

Primary practice location

700 W Grove St
El Dorado, AR 71730-4416

Mailing address

7100 Commerce Way
Suite 180
Brentwood, TN 37027-2829
Phone (615) 465-7000

Other practice location 1

620 W Grove St Ste 202
El Dorado, AR 71730-4425
Phone (870) 924-5680

Other identifiers 1

IdentifierTypeStateIssuer
145507002MedicaidAR

National Provider Directory

National Provider Directory

Locations

460 W Oak St
Ste 402
El Dorado, AR 71730
Phone (870) 862-5184

460 W Oak St
Ste 601
El Dorado, AR 71730
Phone (870) 863-2515

460 W Oak St
Ste 602
El Dorado, AR 71730

501 Hudson St
El Dorado, AR 71730
Phone (870) 862-5511

620 W Grove St
Ste 201
El Dorado, AR 71730
Phone (870) 864-3352

700 W Grove St
#2N
El Dorado, AR 71730
Phone (870) 863-2379

700 W Grove St
#P
El Dorado, AR 71730

700 W Grove St
Ste 2N
El Dorado, AR 71730
Phone (870) 875-5540

704 W Grove St
Ste 1
El Dorado, AR 71730
Phone (870) 863-2368

704 W Grove St
Ste 3
El Dorado, AR 71730
Phone (870) 863-6133

1705 Eastridge Dr
Magnolia, AR 71753
Phone (870) 901-7299

Practitioners & affiliated clinicians

Practitioners 59

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 59

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646438400000",
    "number": "1427018704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 COMMERCE WAY",
            "address_2": "SUITE 180",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272829",
            "telephone_number": "615-465-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W GROVE ST",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304416",
            "telephone_number": "870-863-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 W Grove St Ste 202",
            "address_purpose": "LOCATION",
            "city": "El Dorado",
            "state": "AR",
            "postal_code": "717304425",
            "country_code": "US",
            "telephone_number": "870-924-5680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH ARKANSAS PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2022-03-05",
        "certification_date": "2022-03-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR. DIRECTOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "877-892-9815"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145507002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2022; 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.