NPIMap

Organization Active NPI

East Arkansas Family Health Center, Inc.

Doing business as Earle Family Health Center

  • General Practice Dentistry
  • Earle, AR
National Provider Identifier
1649704156
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3720 Issued in AR
Legal business name
EAST ARKANSAS FAMILY HEALTH CENTER, INC.
Doing business as
Earle Family Health Center
Practice address
216 Arkansas St
Earle, AR 72331-2217
Phone
(870) 792-7676
Fax
(870) 792-7605
NPI assigned
Apr 12, 2017
Last updated
Nov 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Authorized official

Name
Consandra Johnson
Title
Billing Clerk
Phone
(870) 733-6389

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3720 AR Primary

Addresses

Primary practice location

216 Arkansas St
Earle, AR 72331-2217

Mailing address

900 N 7TH St
West Memphis, AR 72301-2001
Phone (870) 735-3846

Other names 1

  • Earle Family Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Arkansas Family HL17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1649704156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N 7TH ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723012001",
            "telephone_number": "870-735-3846",
            "fax_number": "870-394-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 ARKANSAS ST",
            "city": "EARLE",
            "state": "AR",
            "postal_code": "723312217",
            "telephone_number": "870-792-7676",
            "fax_number": "870-792-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST ARKANSAS FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CONSANDRA",
        "authorized_official_title_or_position": "BILLING CLERK",
        "authorized_official_telephone_number": "870-733-6389"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Earle Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Earle Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Earle, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.