Active NPI
Cardiology Associates of Jonesboro, Inc
- Cardiovascular Disease Physician
- Jonesboro, AR
National Provider Identifier
1649570425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- CARDIOLOGY ASSOCIATES OF JONESBORO, INC
- Practice address
- 201 E Oak Ave
Jonesboro, AR 72401-4163 - Phone
- (870) 935-6729
- Fax
- (870) 268-4478
- NPI assigned
- Oct 27, 2010
- 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
- Connie H Hill
- Title
- Vice President Patient Services
- Phone
- (870) 935-6729
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | Primary |
Addresses
Primary practice location
201 E Oak Ave
Jonesboro, AR 72401-4163
Mailing address
201 E Oak Ave
Jonesboro, AR 72401-4163
Phone (870) 935-6729
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 188119002 | 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 |
|---|---|---|---|---|
| O20110204000602 | AR | Part B Supplier - Clinic/Group Practice | 8224218425 | Practice locations: Jonesboro, AR |
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 |
|---|---|---|---|
| 04D0936267 | Cardiology Associates of Jonesboro | Certificate of waiver | Nov 17, 2027 |
National Provider Directory
National Provider DirectoryLocations
201 Floyd St
Kennett, MO 63857
Phone (573) 888-4226
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288137600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1584316800000",
"number": "1649570425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E OAK AVE",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724014163",
"telephone_number": "870-935-6729",
"fax_number": "870-268-4478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 E OAK AVE",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724014163",
"telephone_number": "870-935-6729",
"fax_number": "870-268-4478"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARDIOLOGY ASSOCIATES OF JONESBORO, INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-10-27",
"last_updated": "2020-03-16",
"certification_date": "2020-03-16",
"status": "A",
"authorized_official_last_name": "HILL",
"authorized_official_first_name": "CONNIE",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "VICE PRESIDENT PATIENT SERVICES",
"authorized_official_telephone_number": "870-935-6729"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "188119002",
"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 Mar 16, 2020; 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.