Organization Active NPI

St. Bernards Urology Associates, Inc.

  • Urology Physician
  • Jonesboro, AR
National Provider Identifier
1790116150
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ST. BERNARDS UROLOGY ASSOCIATES, INC.
Practice address
303 E Matthews Ave
Jonesboro, AR 72401-3150
Phone
(870) 932-2926
NPI assigned
Dec 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Authorized official

Name
Mr. John Lieblong
Title
VP Physician Services
Phone
(870) 932-7024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

303 E Matthews Ave
Jonesboro, AR 72401-3150

Mailing address

303 E Matthews Ave
Jonesboro, AR 72401-3150
Phone (870) 932-2926

National Provider Directory

National Provider Directory

Locations

303 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 932-2926

623 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 536-4100

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1790116150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013150",
            "telephone_number": "870-932-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013150",
            "telephone_number": "870-932-2926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. BERNARDS UROLOGY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "LIEBLONG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "870-932-7024",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 10, 2013; 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.