Harrison Pediatrics

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

MC-3097 Issued in AR

Legal business name

HARRISON PEDIATRICS

Practice address

1418 McCoy Dr
Harrison, AR 72601-2411

Phone

(870) 391-5903

Fax

(870) 743-4641

NPI assigned

Dec 22, 2015

Last updated

Dec 22, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Soma Ghosh

Title

Office Manager

Phone

(870) 391-5903

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1467817148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 MCCOY DR",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012411",
            "telephone_number": "870-391-5903",
            "fax_number": "870-743-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 MCCOY DR",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012411",
            "telephone_number": "870-391-5903",
            "fax_number": "870-743-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISON PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "GHOSH",
        "authorized_official_first_name": "SOMA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-391-5903"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "AR",
            "license": "MC-3097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210549002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harrison Dialysis LLC
• Harrison Family Practice Clinic
• Harrison Family Practice Clinic, PA
• Harrison Healthcare LLC
• Harrison Mediquick PA
• Harrison Physical Therapy, Inc.
• Harrison Retirement Center
• Harrison School District
• Harrison Surgery Center, LLC
• Harrison Urology Clinic P.a.

• Preferred Provider Organization in Harrison, AR
• Providers in Harrison, AR by specialty
• Preferred Provider Organization in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.