Individual provider Active NPI

Nephertiti Efeovbokhan, M.D.

  • Cardiovascular Disease Physician
  • Jonesboro, AR
National Provider Identifier
1679738538
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
E-8188 Issued in AR
Practice address
4802 E Johnson Ave
Jonesboro, AR 72401-8413
Phone
(870) 936-8000
Fax
(870) 934-3630
NPI assigned
Jul 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME124080 FL
Cardiovascular Disease Physician 207RC0000X E-8188 AR Primary

Addresses

Primary practice location

4802 E Johnson Ave
Jonesboro, AR 72401-8413

Mailing address

PO Box 1960
Jonesboro, AR 72403-1960
Phone (870) 936-8000

Other identifiers 1

IdentifierTypeStateIssuer
201183001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131220001293 AR Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7719123397 Reassigns benefits to 1 organization
I20151118000033 FL Practitioner - Internal Medicine 7719123397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Arkansas Clinic Charitable Foundation, Inc.Group PAC ID 2961547526, 294 clinicians

Practice addresses (Care Compare)

1111 Windover Rd
Jonesboro, AR 72401-6159
Phone (870) 935-5432

2205 W Parker Rd
Jonesboro, AR 72404-7778
Phone (870) 933-9250

3054 W State Hwy 18
Manila, AR 72442-8201
Phone (870) 936-4500

4700 W Kingshighway
Paragould, AR 72450-3465
Phone (870) 240-8402

4800 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000

4802 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000

4808 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000

51 Choctaw Trce
Cherokee Village, AR 72529-2702
Phone (870) 856-2862

516 Industrial Park Dr
Trumann, AR 72472-9602
Phone (870) 935-8388

616 W Keiser Ave
Osceola, AR 72370-3504
Phone (870) 563-5888

Hospital & facility affiliations

  • Baptist Memorial Hospital Jonesboro, Inc. Hospital, Jonesboro, AR, CCN 040118
  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020
  • Baptist Memorial Hospital-Crittenden, Inc Hospital, West Memphis, AR, CCN 040156
  • Arkansas Methodist Medical Center Hospital, Paragould, AR, CCN 040039
  • Great River Medical Center Hospital, Blytheville, AR, CCN 040069

Merit-based Incentive Payment System (MIPS)

Final score
75.65 of 100Reported as group
Quality
44.87
Promoting interoperability
100
Improvement activities
40
Cost
73.98

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting49
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Current Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Past Accepting new patients

Locations

4802 E Johnson Ave
Jonesboro, AR 72405
Phone (901) 227-9820

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1111 Windover Rd
Jonesboro, AR 72401
Phone (870) 935-5432

1200 Riverplace Blvd
Ste 620
Jacksonville, FL 32207
Phone (904) 396-6620

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Interoperability endpoints

  • Direct secure messaging: nefeovbokhan79685@direct.bmhcc.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679738538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1960",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031960",
            "telephone_number": "870-936-8000",
            "fax_number": "870-934-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 E JOHNSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724018413",
            "telephone_number": "870-936-8000",
            "fax_number": "870-934-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EFEOVBOKHAN",
        "first_name": "NEPHERTITI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME124080",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "E-8188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201183001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.