NPIMap

Organization Active NPI

Jefferson Hospital Association

Doing business as Shah Family Medicine

  • Clinic/Center
  • Pine Bluff, AR
National Provider Identifier
1730351941
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
E4113 Issued in AR
Legal business name
JEFFERSON HOSPITAL ASSOCIATION
Doing business as
Shah Family Medicine
Practice address
1801 W 40TH Ave
Suite 4B
Pine Bluff, AR 71603-6940
Phone
(870) 535-4640
NPI assigned
Mar 27, 2008
Last updated
Apr 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Mr. Robert P Atkinson
Title
President
Phone
(870) 541-7269

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X E4113 AR Primary

Addresses

Primary practice location

1801 W 40TH Ave
Suite 4B
Pine Bluff, AR 71603-6940

Mailing address

1801 W 40TH Ave
Suite 4B
Pine Bluff, AR 71603-6940
Phone (870) 535-4640

Other names 1

  • SHAH FAMILY MEDICINE Doing business as

National Provider Directory

National Provider Directory

Locations

1801 W 40th Ave
Ste 4B
Pine Bluff, AR 71603
Phone (870) 535-4640

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": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1730351941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W 40TH AVE",
            "address_2": "SUITE 4B",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036940",
            "telephone_number": "870-535-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W 40TH AVE",
            "address_2": "SUITE 4B",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036940",
            "telephone_number": "870-535-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "ATKINSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-541-7269",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AR",
            "license": "E4113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHAH FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.