Ameris of Arkansas

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

AMERIS OF ARKANSAS

Practice address

1100 Medical Drive
Blytheville, AR 72315

Phone

(870) 762-6725

Fax

(870) 762-8125

NPI assigned

Jun 4, 2006

Last updated

Jun 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Denis Wellington Miller

Title

Director

Phone

(870) 762-1190

Specialties & licenses 4

Addresses

Other names 1

• Ameris Other name

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1609814185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 N DIVISION ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723151448",
            "telephone_number": "870-762-6725",
            "fax_number": "870-762-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MEDICAL DRIVE",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "72315",
            "telephone_number": "870-762-6725",
            "fax_number": "870-762-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERIS OF ARKANSAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DENIS",
        "authorized_official_middle_name": "WELLINGTON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "870-762-1190"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ameris",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Al Blytheville Operations, LLC (Elmcroft of Blytheville)
• Alayna Hattenhauer DDS PLLC
• Fadila Alisic
• Nicole Rene' Allen
• Allied Health Connect Associated LLC
• Ameris of Arkansas LLC (Great River Medical Center)
• 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

• Internal Medicine Physician in Blytheville, AR
• Providers in Blytheville, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.