First US Clinic PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

E-3124 Issued in AR

Legal business name

FIRST US CLINIC PA

Practice address

1801 W 40TH Ave Ste 1C
Pine Bluff, AR 71603-6956

Phone

(870) 535-4141

Fax

(870) 535-9180

NPI assigned

Aug 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Olabode Olumofin, MDNPI 1720025513

Title

President

Phone

(870) 534-6800

Specialties & licenses 1

Addresses

Other names 1

• Olabode Olumofin MD Other name

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

First US Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Firt US Clinic Inc

  • Primary Care Clinic/Center
  • Pine Bluff, AR
  • NPI 1760610505
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DEHICA

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olabode Olumofin, M.D.

  • Internal Medicine Physician
  • Pine Bluff, AR
  • NPI 1720025513
  Medicare reassignment Authorized official
• Margo Elaine Johnson, R.D., L.D.

  • Registered Dietitian
  • Little Rock, AR
  • NPI 1235296773
  NPD (past)
• Steven Howard Wright, M.D.

  • Internal Medicine Physician
  • Pine Bluff, AR
  • NPI 1598771677
  NPD (past)

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1750513982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W 40TH AVE STE 1C",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036956",
            "telephone_number": "870-535-4141",
            "fax_number": "870-535-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W 40TH AVE STE 1C",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036956",
            "telephone_number": "870-535-4141",
            "fax_number": "870-535-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST US CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-21",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "OLUMOFIN",
        "authorized_official_first_name": "OLABODE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-534-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-3124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olabode Olumofin MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Family Medicine Podiatry
• Herbert F Fendley, MD
• Meagan Fenters
• Robert Ferguson, MD
• Jeffrey Harold Fergusson, DC
• Firt US Clinic Inc
• Felicia Ann Fisher
• Maxwell U Fleming Jr., DDS
• Flowers Pediatraic Clinic
• Flowers Pharmacy

• Internal Medicine Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.