NPIMap

Organization Active NPI

Ascension Depaul Services

  • Rural Health Clinic/Center
  • Gould, AR
National Provider Identifier
1689775231
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ASCENSION DEPAUL SERVICES
Practice address
407 South Gould Ave
Gould, AR 71643-0370
Phone
(870) 263-4317
Fax
(870) 263-4782
NPI assigned
Sep 26, 2006
Organization subpart
Yes
Parent organization
ASCENSION DEPAUL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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

Authorized official

Name
Laurie Jan Stephenson
Title
Director of Integrated Services
Phone
(870) 382-3080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

407 South Gould Ave
Gould, AR 71643-0370

Mailing address

PO Box 158
Dumas, AR 71639-0158
Phone (870) 382-3080

Other identifiers 1

IdentifierTypeStateIssuer
168848729MedicaidAR

Other names 2

  • DePaul Community Health Centers - Gould Doing business as
  • St Elizabeth Health Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Ascension Depaul Services2 organizations share this tax ID, including this one
Part of
Depaul Health Center

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575504000000",
    "number": "1689775231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "DUMAS",
            "state": "AR",
            "postal_code": "716390158",
            "telephone_number": "870-382-3080",
            "fax_number": "870-382-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 SOUTH GOULD AVE",
            "city": "GOULD",
            "state": "AR",
            "postal_code": "716430370",
            "telephone_number": "870-263-4317",
            "fax_number": "870-263-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION DEPAUL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASCENSION DEPAUL SERVICES",
        "enumeration_date": "2006-09-26",
        "last_updated": "2019-12-05",
        "status": "A",
        "authorized_official_last_name": "STEPHENSON",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "JAN",
        "authorized_official_title_or_position": "DIRECTOR OF INTEGRATED SERVICES",
        "authorized_official_telephone_number": "870-382-3080"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168848729",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DePaul Community Health Centers - Gould",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Elizabeth Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gould, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.