Active NPI
Ronald J Blachly, M.D.
- Hematology & Oncology Physician
- Jonesboro, AR
National Provider Identifier
1689643751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- C-5559
- Practice address
- 4808 E Johnson Ave
Jonesboro, AR 72401-8413 - Phone
- (870) 936-7000
- Fax
- (870) 934-3677
- NPI assigned
- Mar 14, 2006
- Last updated
- Jan 22, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | C-5559 | AR | Primary |
Addresses
Primary practice location
4808 E Johnson Ave
Jonesboro, AR 72401-8413
Mailing address
PO Box 1960
Jonesboro, AR 72403-1960
Phone (870) 935-4150
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110171001 | Medicaid | AR | |
| 202589503 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Arkansas Clinic, PA | Past | Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba NEA Baptist Clinic
- Clinical Medical Laboratory
- Jonesboro, AR
- NPI 1801127030
-
dba NEA Clinic
- Multi-Specialty Clinic/Center
- Jonesboro, AR
- NPI 1376517177
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390348800000",
"number": "1689643751",
"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": "870-935-4150",
"fax_number": "870-934-5344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4808 E JOHNSON AVE",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724018413",
"telephone_number": "870-936-7000",
"fax_number": "870-934-3677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACHLY",
"first_name": "RONALD",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2014-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "AR",
"license": "C-5559",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110171001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202589503",
"state": "MO"
}
],
"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 Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.