NPIMap

Organization Active NPI

Ascent Acquisitions Corp-Cypdc

Doing business as Child & Youth Pediatric Day Clinic

  • Developmentally Disabled Services Day Training Agency
  • Trumann, AR
National Provider Identifier
1790818334
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
ASCENT ACQUISITIONS CORP-CYPDC
Doing business as
Child & Youth Pediatric Day Clinic
Practice address
1005 Balcom LN
Trumann, AR 72472-9502
Phone
(870) 483-1461
Fax
(870) 483-6520
NPI assigned
Mar 13, 2007
Last updated
Apr 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Holly Allgood
Title
Billing Specialist
Phone
(870) 819-0232

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary
Clinical Child & Adolescent Psychologist 103TC2200X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

1005 Balcom LN
Trumann, AR 72472-9502

Mailing address

3012 Turman Dr
Jonesboro, AR 72404-8998
Phone (870) 819-0200

Other identifiers 4

IdentifierTypeStateIssuer
160747526MedicaidAR
160750724MedicaidAR
160757742MedicaidAR
5C363OtherARBCBS

Other names 1

  • CHILD & YOUTH PEDIATRIC DAY CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ascent Acquisitions Corp-Cypdc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1005 Balcom Ln
Trumann, AR 72472
Phone (870) 418-1000

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1790818334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 TURMAN DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048998",
            "telephone_number": "870-819-0200",
            "fax_number": "870-819-0217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BALCOM LN",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "724729502",
            "telephone_number": "870-483-1461",
            "fax_number": "870-483-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENT ACQUISITIONS CORP-CYPDC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "ALLGOOD",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "870-819-0232"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160747526",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160750724",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160757742",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5C363",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHILD & YOUTH PEDIATRIC DAY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trumann, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.