Active NPI
Digestive Care P a
- Gastroenterology Physician
- Pine Bluff, AR
National Provider Identifier
1629030358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Legal business name
- DIGESTIVE CARE P A
- Practice address
- 4800 S Hazel St
Pine Bluff, AR 71603-6860 - Phone
- (870) 534-5533
- Fax
- (870) 534-5535
- NPI assigned
- Apr 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Frances Stucks
- Title
- Administrator
- Phone
- (870) 534-5533
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | Primary |
Addresses
Primary practice location
4800 S Hazel St
Pine Bluff, AR 71603-6860
Mailing address
PO Box 2797
Pine Bluff, AR 71613-2797
Phone (870) 534-5533
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12162000000 | Other | QUAL CHOICE | |
| 5B793 | Other | AR | BLUE CROSS BLUE SHIELD |
| DG3779 | Other | AR | RAILROAD MEDICARE |
| 4600296 | Other | AETNA | |
| 2920027 | Other | UNITED HEALTHCARE | |
| 129049002 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100826000026 | AR | Part B Supplier - Clinic/Group Practice | 7810011905 |
Receives reassigned benefits from 7 practitioners 1 other NPI on this enrollment Practice locations: Little Rock, AR; Russellville, AR; Pine Bluff, AR |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0891055 | Digestive Care, PA | Compliance | Apr 12, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Digestive Care P a
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Gastroenterology Physician
- Russellville, AR
- NPI 1699539023
-
- Gastroenterology Physician
- Little Rock, AR
- NPI 1124299599
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Pine Bluff, AR
- NPI 1013250554
AR, Gastroenterology
-
- Gastroenterology Physician
- Little Rock, AR
- NPI 1700931755
AR, Gastroenterology
-
- Gastroenterology Physician
- Pine Bluff, AR
- NPI 1265420830
AR, Gastroenterology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1284422400000",
"number": "1629030358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2797",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716132797",
"telephone_number": "870-534-5533",
"fax_number": "870-534-5535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 S HAZEL ST",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716036860",
"telephone_number": "870-534-5533",
"fax_number": "870-534-5535"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIGESTIVE CARE P A",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-06",
"last_updated": "2010-09-14",
"status": "A",
"authorized_official_last_name": "STUCKS",
"authorized_official_first_name": "FRANCES",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "870-534-5533",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUAL CHOICE",
"identifier": "12162000000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5B793",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DG3779",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4600296",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2920027",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129049002",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.