NPIMap

Organization Active NPI

Northeast Arkansas Community Mental Health Center

Doing business as MidSouth Health Systems

  • Community/Behavioral Health Agency
  • West Memphis, AR
National Provider Identifier
1598058489
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER
Doing business as
MidSouth Health Systems
Practice address
905 N 7TH St
West Memphis, AR 72301-2001
Phone
(870) 735-4511
Fax
(870) 735-5260
NPI assigned
May 25, 2011
Last updated
Dec 12, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Donnie Lyerly
Title
Credentialing
Phone
(870) 972-4939

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

905 N 7TH St
West Memphis, AR 72301-2001

Mailing address

2707 Browns LN
Jonesboro, AR 72401-7213
Phone (870) 972-4939

Other identifiers 1

IdentifierTypeStateIssuer
18417774MedicaidAR

Other names 1

  • MidSouth Health Systems Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mid-South Health System43 organizations share this tax ID, including this one
Part of
Mid-South Health System

Other organizations with this tax ID 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1598058489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 BROWNS LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017213",
            "telephone_number": "870-972-4939",
            "fax_number": "870-972-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N 7TH ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723012001",
            "telephone_number": "870-735-4511",
            "fax_number": "870-735-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER",
        "enumeration_date": "2011-05-25",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "LYERLY",
        "authorized_official_first_name": "DONNIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "870-972-4939"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18417774",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MidSouth Health Systems",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Memphis, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.