NPIMap

Organization Active NPI

South Arkansas Regional Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • El Dorado, AR
National Provider Identifier
1467423384
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SOUTH ARKANSAS REGIONAL HEALTH CENTER
Practice address
715 N College Ave
El Dorado, AR 71730-4403
Phone
(870) 862-7921
Fax
(870) 864-2490
NPI assigned
Jan 30, 2006
Last updated
Apr 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

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

Authorized official

Name
William C Peel, PHD
Title
Executive Director
Phone
(870) 862-7921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

715 N College Ave
El Dorado, AR 71730-4403

Mailing address

715 N College Ave
El Dorado, AR 71730-4403
Phone (870) 862-7921

Other identifiers 1

IdentifierTypeStateIssuer
116377726MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315001172 AR Part B Supplier - Clinic/Group Practice 0941199988 Receives reassigned benefits from 23 practitioners
1 other NPI on this enrollment
Practice locations: Camden, AR; El Dorado, AR; Fordyce, AR; Magnolia, AR

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
South Arkansas Regional Health Center Community Support Program17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

211 Jackson St SW
Camden, AR 71701
Phone (870) 836-5743

750 N Flenniken Ave
Ste B
El Dorado, AR 71730
Phone (870) 639-6820

412 N Vine
Magnolia, AR 71753
Phone (870) 234-7500

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240876800000",
    "number": "1467423384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N COLLEGE AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304403",
            "telephone_number": "870-862-7921",
            "fax_number": "870-864-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N COLLEGE AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304403",
            "telephone_number": "870-862-7921",
            "fax_number": "870-864-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ARKANSAS REGIONAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2009-04-28",
        "status": "A",
        "authorized_official_last_name": "PEEL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "870-862-7921",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116377726",
            "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 Apr 28, 2009; 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.