The Pediatric Clinic of NLR, P.a.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

THE PEDIATRIC CLINIC OF NLR, P.A.

Practice address

203B Plaza Blvd
Cabot, AR 72023-3749

Phone

(501) 843-0068

Fax

(501) 843-0696

NPI assigned

Aug 5, 2021

Organization subpart

Yes

Parent organization

THE PEDIATRIC CLINIC OF NLR, P.A.As reported in NPPES

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

Authorized official

Name

Tonya Sims, RN

Title

Administrator

Phone

(501) 758-1530

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Pediatric Clinic Doing business as

Tax ID family

The Pediatric Clinic2 organizations share this tax ID, including this one

Part of

The Pediatric Clinic

Other organizations with this tax ID 1

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

• The Pediatric Clinic of NLR, P.a.

  • Medical Specialty Clinic/Center
  • Sherwood, AR
  • NPI 1588692198
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• The Pediatric Clinic of NLR, P.a.

  • Medical Specialty Clinic/Center
  • Sherwood, AR
  • NPI 1588692198
  NPPES parent name

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lourie A Battles, M.D.

  • Pediatrics Physician
  • Sherwood, AR
  • NPI 1962424465
  NPD (past)
• Kimberly Suzanne Clinton, MD

  • Pediatrics Physician
  • Sherwood, AR
  • NPI 1790701555
  NPD (past)
• Stephen C Fiedorek, M.D.

  • Pediatric Gastroenterology Physician
  • Sherwood, AR
  • NPI 1609898006
  NPD (past)
• Kimberly Nix Hurlbut, M.D.

  • Pediatrics Physician
  • Sherwood, AR
  • NPI 1669407730
  NPD (past)
• Holly Ann Montgomery, MD

  • Pediatrics Physician
  • Sherwood, AR
  • NPI 1609295922
  NPD (past)
• Bishawn Watson Morris, M.D.

  • Pediatrics Physician
  • Sherwood, AR
  • NPI 1518985753
  NPD (past)
• Timothy Onarecker, MD

  • Pediatric Infectious Diseases Physician
  • Sherwood, AR
  • NPI 1427493618
  NPD (past)
• William Robert Still III, M.D.

  • Pediatrics Physician
  • Sherwood, AR
  • NPI 1427314640
  NPD (past)

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1669146346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 COUNTRY CLUB RD",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721205076",
            "telephone_number": "501-758-1530",
            "fax_number": "501-819-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203B PLAZA BLVD",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720233749",
            "telephone_number": "501-843-0068",
            "fax_number": "501-843-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC CLINIC OF NLR, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE PEDIATRIC CLINIC OF NLR, P.A.",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-758-1530",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180601002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pediatric Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Taylor
• Thomas Taylor, PHARMD.
• Joanne Terry, QBHP
• Morgan Teston, SLP
• The Dietitian Doctor, LLC
• Brenda Lee Thielemier, DC
• Emma Michelle Thompson
• Lynnae Thompson, RN
• Morgan Nicole Tilghman
• Amanda Ryan Timmer

• Medical Specialty Clinic/Center in Cabot, AR
• Providers in Cabot, AR by specialty
• Medical Specialty Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.