NPIMap

Organization Active NPI

Ascension Depaul Services

  • General Practice Dentistry
  • Gould, AR
National Provider Identifier
1689890063
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ASCENSION DEPAUL SERVICES
Practice address
407 South Gould Ave
Gould, AR 71643
Phone
(870) 263-4317
Fax
(870) 263-4782
NPI assigned
Apr 17, 2007
Last updated
Mar 31, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ASCENSION DEPAUL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Authorized official

Name
Lisa Goodgame
Title
Cfo
Phone
(870) 382-3080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

407 South Gould Ave
Gould, AR 71643

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
149324631MedicaidAR

Other names 1

  • Ascension DePaul Services Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jan.stephenson@depaularkansas.org

National Provider Directory

National Provider Directory
Tax ID family
Daughters of Charity Services31 organizations share this tax ID, including this one
Part of
Daughters of Charity Services

Other organizations with this tax ID 30

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

View all 30

Locations

161 S Main St
Dumas, AR 71639
Phone (870) 382-4878

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1689890063",
    "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": "71643",
            "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": "2007-04-17",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "GOODGAME",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-382-3080"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149324631",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jan.stephenson@depaularkansas.org",
            "affiliation": "N",
            "address_1": "161 S Main St",
            "city": "Dumas",
            "state": "AR",
            "country_code": "US",
            "postal_code": "716392222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ascension DePaul Services",
            "code": "5",
            "type": "Other 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 Mar 31, 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.