Organization Active NPI

Tba Texarkana LLC

  • Psychiatry Physician
  • Prescott, AR
National Provider Identifier
1477813012
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
TBA TEXARKANA LLC
Practice address
1484 W 1St St N
Prescott, AR 71857-3339
Phone
(870) 887-1078
Fax
(870) 887-0281
NPI assigned
May 16, 2012
Organization subpart
Yes
Parent organization
AMICARE BEHAVIORAL CENTERS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Authorized official

Name
Kyle Naples
Title
Ceo
Phone
(479) 521-1427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1484 W 1St St N
Prescott, AR 71857-3339

Mailing address

3352 N Futrall Dr
Fayetteville, AR 72703-4057
Phone (479) 521-1427

Other names 1

  • VISTA HEALTH TEXARKANA (PRESCOTT GRP) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Riverview Behavioral Health LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1477813012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3352 N FUTRALL DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034057",
            "telephone_number": "479-521-1427",
            "fax_number": "479-521-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1484 W 1ST ST N",
            "city": "PRESCOTT",
            "state": "AR",
            "postal_code": "718573339",
            "telephone_number": "870-887-1078",
            "fax_number": "870-887-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TBA TEXARKANA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMICARE BEHAVIORAL CENTERS LLC",
        "enumeration_date": "2012-05-16",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "NAPLES",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "479-521-1427"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VISTA HEALTH TEXARKANA (PRESCOTT GRP)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.