NPIMap

Organization Active NPI

East Arkansas Family Health Center Inc.

Doing business as Healthy Partners

  • Federally Qualified Health Center (FQHC)
  • Blytheville, AR
National Provider Identifier
1659506095
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EAST ARKANSAS FAMILY HEALTH CENTER INC.
Doing business as
Healthy Partners
Practice address
605 N 2ND St
Blytheville, AR 72315-2034
Phone
(870) 532-6001
Fax
(870) 532-6008
NPI assigned
May 28, 2009
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
Susan E Ward-Jones, M.D.NPI 1851368740
Title
Ceo
Phone
(870) 733-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

605 N 2ND St
Blytheville, AR 72315-2034

Mailing address

900 N 7TH St
West Memphis, AR 72301-2001
Phone (870) 735-3842

Other identifiers 1

IdentifierTypeStateIssuer
179761749MedicaidAR

Other names 1

  • Healthy Partners Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090729000855 AR Part A Provider - Federally Qualified Health Center (FQHC) 1052390390 Practice locations: Blytheville, AR
O20101006000058 AR Part B Supplier - Clinic/Group Practice 1052390390 Receives reassigned benefits from 21 practitioners
1 other NPI on this enrollment
Practice locations: Blytheville, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659506095. Details of each certification follow.

Federally qualified health center certification: CCN 041870

Legal name
EAST ARKANSAS FAMILY HEALTH CENTER, INC
Doing business as
HEALTHY PARTNERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 11, 2009
Last certification
Aug 11, 2009
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Nov 1, 1973 in AR
Enrollment address
605 N 2ND St
Blytheville, AR 72315-2034

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Reena Holmes Individual Corporate OfficerCfo Jan 1, 2021
Susan Ward Jones Individual Corporate Director Jun 29, 2009
W-2 Managing Employee Jun 29, 2009 100%
Larry Robinson Individual Corporate DirectorBoard Member Jun 18, 2014
Cynthia Conner Individual Corporate DirectorBoard Member Sep 9, 2016
Randall S Burcham Individual Corporate DirectorBoard Member May 26, 2015
Kyle Miller Individual Corporate DirectorBoard Member Sep 23, 2019
Sara Joplin Individual Corporate DirectorBoard Member Aug 24, 2020
Dewayne Rose Individual Corporate DirectorBoard Member Feb 1, 2023
Sandra Teague Individual Corporate DirectorBoard Member Nov 1, 2013
Tracy Evans Individual Corporate DirectorBoard Chair May 26, 2015

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marion School District School Based Health CenterMarion, AR, CCN 041941 Federally qualified health center Operational/Managerial Control (100%) Aug 13, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1659506095",
    "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": "870-735-3842",
            "fax_number": "870-732-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N 2ND ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152034",
            "telephone_number": "870-532-6001",
            "fax_number": "870-532-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST ARKANSAS FAMILY HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-28",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "WARD-JONES",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-733-6300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179761749",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Partners",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blytheville, AR

Sources for this page

Verify at the official NPI Registry.