NPIMap

Organization Active NPI

Northeast Arkansas Clinic Charitable Foundation, Inc

Doing business as NEA Baptist Clinic Imaging Center

  • Radiology Clinic/Center
  • Jonesboro, AR
National Provider Identifier
1790016418
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC
Doing business as
NEA Baptist Clinic Imaging Center
Practice address
3100 Apache Dr
Suite C1
Jonesboro, AR 72401-7404
Phone
(870) 934-5102
Fax
(870) 932-3608
NPI assigned
Jan 20, 2010
Last updated
Sep 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

Name
Mr. Gregory M Duckett
Title
Sr VP/ Clo
Phone
(901) 227-5233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

3100 Apache Dr
Suite C1
Jonesboro, AR 72401-7404

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177

Other names 1

  • NEA Baptist Clinic Imaging Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Arkansas Clinic7 organizations share this tax ID, including this one
Part of
Baptist Memorial Health Care Corp

Other organizations with this tax ID 6

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": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1790016418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 APACHE DR",
            "address_2": "SUITE C1",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017404",
            "telephone_number": "870-934-5102",
            "fax_number": "870-932-3608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
        "enumeration_date": "2010-01-20",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP/ CLO",
        "authorized_official_telephone_number": "901-227-5233",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEA Baptist Clinic Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NEA Baptist Clinic Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.