Organization Active NPI

Mid-South Neurosurgery, Inc.

  • Neurological Surgery Physician
  • Jonesboro, AR
National Provider Identifier
1518920404
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
MID-SOUTH NEUROSURGERY, INC.
Practice address
800 S. Church
Suite 203
Jonesboro, AR 72401
Phone
(870) 932-3850
Fax
(870) 932-5699
NPI assigned
Apr 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. J Matt Parker
Title
President
Phone
(870) 932-7024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

800 S. Church
Suite 203
Jonesboro, AR 72401

Mailing address

P.O. Box 6004
Jonesboro, AR 72403
Phone (870) 932-3850

Other identifiers 1

IdentifierTypeStateIssuer
DC9398OtherARRAILROAD

National Provider Directory

National Provider Directory

Locations

800 S Church St
Fl 2
Jonesboro, AR 72401
Phone (870) 879-2431

Practitioners & affiliated clinicians

Practitioners 4

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": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518920404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6004",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72403",
            "telephone_number": "870-932-3850",
            "fax_number": "870-932-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S. CHURCH",
            "address_2": "SUITE 203",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-932-3850",
            "fax_number": "870-932-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH NEUROSURGERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "MATT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-932-7024",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DC9398",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.