Clarksville Medical Group, P.a.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

MC0283 Issued in AR

Legal business name

CLARKSVILLE MEDICAL GROUP, P.A.

Practice address

601 W McKennon St
Clarksville, AR 72830-3523

Phone

(479) 754-8384

Fax

(479) 754-7141

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Leanna J Perrett

Title

Office Manager

Phone

(479) 754-8384

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Clarksville Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Clarksville Medical Group, P.a.

  • Family Medicine Physician
  • Clarksville, AR
  • NPI 1447253810
  NPD tax ID

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1508918467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728300668",
            "telephone_number": "479-754-8384",
            "fax_number": "479-754-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W MCKENNON ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303523",
            "telephone_number": "479-754-8384",
            "fax_number": "479-754-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSVILLE MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "PERRETT",
        "authorized_official_first_name": "LEANNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-754-8384"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "MC0283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DURABLE MEDICAL EQUIPMENT",
            "identifier": "0790780001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarksville Dentistry, Inc.
• Clarksville Family Pharmacy Inc
• Clarksville Health & Rehab,LLC
• Clarksville Medical Group, P.a.
• Clarksville Medical Group, P.a.
• Clarksville Nursing and Rehab, LLC
• Clarksville Retirement Center
• Emily Coffman, PHARMD
• Sahara Collins
• Sherri Selma Collins, MSN, APN, FNP

• Durable Medical Equipment & Medical Supplies in Clarksville, AR
• Providers in Clarksville, AR by specialty
• Durable Medical Equipment & Medical Supplies in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.