Organization Active NPI

Stuttgart Regional Medical Center

Doing business as Brinkley Medical Clinic

  • Family Medicine Physician
  • Brinkley, AR
National Provider Identifier
1710003579
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
STUTTGART REGIONAL MEDICAL CENTER
Doing business as
Brinkley Medical Clinic
Practice address
110 N New York Ave
Brinkley, AR 72021-2722
Phone
(870) 734-4405
Fax
(870) 734-3438
NPI assigned
Mar 22, 2007
Last updated
Oct 25, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
STUTTGART REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Lura Wilson
Title
Clinic Administrator
Phone
(870) 674-6783

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

110 N New York Ave
Brinkley, AR 72021-2722

Mailing address

110 N New York Ave
Brinkley, AR 72021-2722
Phone (870) 734-4405

Other names 1

  • Brinkley Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Monroe Cnty Amb Service2 organizations share this tax ID, including this one
Part of
Monroe Cnty Amb Service

Other organizations with this tax ID 1

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

Locations

110 N New York Ave
Brinkley, AR 72021
Phone (501) 734-4405

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1710003579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N NEW YORK AVE",
            "city": "BRINKLEY",
            "state": "AR",
            "postal_code": "720212722",
            "telephone_number": "870-734-4405",
            "fax_number": "870-734-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N NEW YORK AVE",
            "city": "BRINKLEY",
            "state": "AR",
            "postal_code": "720212722",
            "telephone_number": "870-734-4405",
            "fax_number": "870-734-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUTTGART REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STUTTGART REGIONAL MEDICAL CENTER",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LURA",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "870-674-6783"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brinkley Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brinkley, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.