NPIMap

Organization Active NPI

St Johns Clinic Inc

  • Advanced Practice Midwife
  • Berryville, AR
National Provider Identifier
1447439633
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
M00127 Issued in AR
Legal business name
ST JOHNS CLINIC INC
Practice address
613 Orchard Dr
Berryville, AR 72616-5013
Phone
(870) 423-4240
Fax
(870) 423-4241
NPI assigned
Oct 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Donn E. Sorensen
Title
Senior Vice President/Coo
Phone
(417) 829-4264

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice MidwifeGroup: 193400000X SINGLE SPECIALTY GROUP 367A00000X M00127 AR Primary

Addresses

Primary practice location

613 Orchard Dr
Berryville, AR 72616-5013

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

National Provider Directory

National Provider Directory
Tax ID family
Springfield Clinic Nucl55 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 8

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

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": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1447439633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 ORCHARD DR",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726165013",
            "telephone_number": "870-423-4240",
            "fax_number": "870-423-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHNS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "DONN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT/COO",
        "authorized_official_telephone_number": "417-829-4264"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "AR",
            "license": "M00127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berryville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.