Individual provider Active NPI

Sara Elsie Gramling Van Scoy, MD

  • Psychiatry Physician
  • Jonesboro, AR
National Provider Identifier
1821160151
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
E-1043 Issued in AR
Practice address
2239 S Caraway Rd Ste M
Jonesboro, AR 72401-6234
Phone
(870) 910-3757
Fax
(870) 910-4999
NPI assigned
Nov 14, 2006
Last updated
Jun 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X E-1043 AR Primary

Addresses

Primary practice location

2239 S Caraway Rd Ste M
Jonesboro, AR 72401-6234

Mailing address

1600 Aldersgate Rd Ste 200
Little Rock, AR 72205-6676
Phone (501) 661-0720

Other practice location 1

1817 Woodsprings Rd
Suite G
Jonesboro, AR 72401-0903
Phone (870) 934-9800

Other identifiers 2

IdentifierTypeStateIssuer
137759001MedicaidAR
5L267OtherARBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040422001640 AR Practitioner - Psychiatry 4284620311 Reassigns benefits to 1 organization
I20210505003244 TN Practitioner - Psychiatry 4284620311 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-1043ARMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Hospital Inc CurrentSince Jun 1, 2015 Accepting new patients
St Bernards Hospital Inc. CurrentSince Jun 1, 2015 Accepting new patients
Crestwyn Health Group, LLC Psychiatry CurrentSince Jan 26, 2021 Accepting new patients
St. Bernards Hospital, Inc Current Accepting new patients
St. Bernards Behavioral Health Past Accepting new patients
Southern Mental Health Associates Past Accepting new patients
United Methodist Behavioral Health System, Inc Past Accepting new patients
United Methodist Behavioral Health Systems, Inc Past Accepting new patients
Alternative Opportunities Past Accepting new patients
Crestwyn Health Group, LLC Past Accepting new patients

Locations

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

2712 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 268-4107

6100 Tower Cir
Ste 1000
Franklin, TN 37067
Phone (615) 454-7459

9485 Crestwyn Hills Cv
Memphis, TN 38125
Phone (901) 248-1500

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1821160151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 ALDERSGATE RD STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056676",
            "telephone_number": "501-661-0720",
            "fax_number": "501-325-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 S CARAWAY RD STE M",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016234",
            "telephone_number": "870-910-3757",
            "fax_number": "870-910-4999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1817 Woodsprings Rd",
            "address_2": "SUITE G",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724010903",
            "country_code": "US",
            "telephone_number": "870-934-9800",
            "fax_number": "870-934-8463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAMLING VAN SCOY",
        "first_name": "SARA",
        "middle_name": "ELSIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "E-1043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137759001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5L267",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.