Ameris of Arkansas, LLC

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

License

AR4258 Issued in AR

Legal business name

AMERIS OF ARKANSAS, LLC

Doing business as

Great River Medical Center

Practice address

1520 N Division St
Blytheville, AR 72315-1448

Phone

(870) 838-7213

Fax

(870) 838-7100

NPI assigned

Dec 22, 2006

Organization subpart

No

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

Authorized official

Name

David Lynn

Title

Cfo

Phone

(870) 838-7462

Specialties & licenses 1

Addresses

Other names 1

• Great River Medical Center Doing business as

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548325251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 167",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723160167",
            "telephone_number": "870-838-7213",
            "fax_number": "870-838-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 N DIVISION ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723151448",
            "telephone_number": "870-838-7213",
            "fax_number": "870-838-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERIS OF ARKANSAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LYNN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-838-7462"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "AR",
            "license": "AR4258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great River Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fadila Alisic
• Nicole Rene' Allen
• Allied Health Connect Associated LLC
• Ameris of Arkansas
• Ameris of Arkansas LLC (Great River Medical Center)
• Ameris of Arkansas, LLC (Great River Medical Center)
• Jennifer Eunice Anderson Connell, O.D., M.S., B.S.
• Chiquita La'Tarsha Anderson, AAS
• Christina Anderson
• Valencia Marie Andrews-Pirtle, MD

• Psychiatric Hospital Unit in Blytheville, AR
• Providers in Blytheville, AR by specialty
• Psychiatric Hospital Unit in Arkansas

• 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.