NPIMap

Organization Active NPI

Great River Medical Center LLC

Doing business as Great River Anesthesia Group

  • Certified Registered Nurse Anesthetist
  • Blytheville, AR
National Provider Identifier
1699698811
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
GREAT RIVER MEDICAL CENTER LLC
Doing business as
Great River Anesthesia Group
Practice address
1520 N Division St
Blytheville, AR 72315-1448
Phone
(870) 838-7300
NPI assigned
Aug 3, 2026
Last updated
Aug 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
GREAT RIVER MEDICAL CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Lacey Carter
Title
Ceo
Phone
(870) 838-7460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

1520 N Division St
Blytheville, AR 72315-1448

Mailing address

PO Box 108
Blytheville, AR 72316-0108
Phone (870) 838-7300

Other names 1

  • Great River Anesthesia Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Great River Medical Center LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1785715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1699698811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723160108",
            "telephone_number": "870-838-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 N DIVISION ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723151448",
            "telephone_number": "870-838-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER MEDICAL CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREAT RIVER MEDICAL CENTER LLC",
        "enumeration_date": "2026-08-03",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-838-7460"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great River Anesthesia Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blytheville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.