NPIMap

Organization Active NPI

St Johns Clinic Inc

Doing business as SJC-Eureka Springs

  • Obstetrics & Gynecology Physician
  • Eureka Springs, AR
National Provider Identifier
1487815304
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
R3882 Issued in AR
Legal business name
ST JOHNS CLINIC INC
Doing business as
SJC-Eureka Springs
Practice address
24 Norris St
Eureka Springs, AR 72632-3541
Phone
(479) 253-7400
NPI assigned
Jun 23, 2008
Last updated
Jun 30, 2008By the provider in NPPES
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
Obstetrics & Gynecology Physician 207V00000X R3882 AR Primary

Addresses

Primary practice location

24 Norris St
Eureka Springs, AR 72632-3541

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidAR

Other names 1

  • SJC-EUREKA SPRINGS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
SPFD CL Cancer and Hema55 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 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1487815304",
    "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": "24 NORRIS ST",
            "city": "EUREKA SPRINGS",
            "state": "AR",
            "postal_code": "726323541",
            "telephone_number": "479-253-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHNS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "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": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "R3882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJC-EUREKA SPRINGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka Springs, 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.