NPIMap

Organization Active NPI

Medical Center Clinic of Izard County LLC

  • Family Medicine Physician
  • Calico Rock, AR
National Provider Identifier
1437125366
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL CENTER CLINIC OF IZARD COUNTY LLC
Practice address
35 Grasse Street
Calico Rock, AR 72519
Phone
(870) 297-2475
Fax
(870) 297-4380
NPI assigned
Feb 28, 2006
Organization subpart
No

Practitioners 5

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

National Provider Directory

National Provider Directory

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Authorized official

Name
Dr. Donald O. Wright, M.D.
Title
Chief of Staff
Phone
(870) 297-2475

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

35 Grasse Street
Calico Rock, AR 72519

Mailing address

PO Box 819
Calico Rock, AR 72519-0819
Phone (870) 297-2475

Other identifiers 3

IdentifierTypeStateIssuer
137324002MedicaidAR
5C216OtherBLUE CROSS BLUE SHIELD
93492OtherHEALTH PARTNERS

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1437125366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 819",
            "city": "CALICO ROCK",
            "state": "AR",
            "postal_code": "725190819",
            "telephone_number": "870-297-2475",
            "fax_number": "870-297-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 GRASSE STREET",
            "city": "CALICO ROCK",
            "state": "AR",
            "postal_code": "72519",
            "telephone_number": "870-297-2475",
            "fax_number": "870-297-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER CLINIC OF IZARD COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "CHIEF OF STAFF",
        "authorized_official_telephone_number": "870-297-2475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137324002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5C216",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "93492",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calico Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.