NPIMap

Organization Active NPI

Doctors Health Group, Inc

Doing business as Paragould Doctors' Clinic

  • Primary Care Clinic/Center
  • Paragould, AR
National Provider Identifier
1700849692
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
DOCTORS HEALTH GROUP, INC
Doing business as
Paragould Doctors' Clinic
Practice address
4000 Linwood Drive
Suite a
Paragould, AR 72450-7224
Phone
(870) 239-8503
Fax
(870) 236-1947
NPI assigned
Apr 11, 2006
Last updated
Jun 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Authorized official

Name
Mr. John Lieblong
Title
President
Phone
(870) 932-7024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

4000 Linwood Drive
Suite a
Paragould, AR 72450-7224

Mailing address

4000 Linwood Drive
Suite a
Paragould, AR 72450-7224
Phone (870) 239-8503

Other identifiers 1

IdentifierTypeStateIssuer
130301002MedicaidAR

Other names 1

  • Paragould Doctors' Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070203000166 AR Part B Supplier - Clinic/Group Practice 7315844586 Receives reassigned benefits from 43 practitioners
Practice locations: Paragould, AR

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Paragould Doctors' ClinicParagould, AR, CCN 043822 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 14, 1996
Piggott Family Medical ClinicPiggott, AR, CCN 043834 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 2, 2013

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464825600000",
    "number": "1700849692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 LINWOOD DRIVE",
            "address_2": "SUITE A",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724507224",
            "telephone_number": "870-239-8503",
            "fax_number": "870-236-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 LINWOOD DRIVE",
            "address_2": "SUITE A",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724507224",
            "telephone_number": "870-239-8503",
            "fax_number": "870-236-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS HEALTH GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2016-06-02",
        "status": "A",
        "authorized_official_last_name": "LIEBLONG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-932-7024",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130301002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paragould Doctors' Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.