NPIMap

Organization Active NPI

Pediatric Specialty Care

  • Exclusive Provider Organization
  • Arkadelphia, AR
National Provider Identifier
1831220334
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
P0607039 Issued in AR
Legal business name
PEDIATRIC SPECIALTY CARE
Practice address
2410 Pine St
Arkadelphia, AR 71923-4335
Phone
(870) 245-2210
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Larry Lamar Grant, LPCNPI 1265566400
Title
Mental Health Professional
Phone
(870) 245-2210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X P0607039 AR Primary

Addresses

Primary practice location

2410 Pine St
Arkadelphia, AR 71923-4335

Mailing address

141 Grisham Rd
Royal, AR 71968-9563
Phone (501) 282-2750

National Provider Directory

National Provider Directory
Tax ID family
Ascent Acquisitions Corp-PSC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831220334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 GRISHAM RD",
            "city": "ROYAL",
            "state": "AR",
            "postal_code": "719689563",
            "telephone_number": "501-282-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 PINE ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719234335",
            "telephone_number": "870-245-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SPECIALTY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "LAMAR",
        "authorized_official_title_or_position": "MENTAL HEALTH PROFESSIONAL",
        "authorized_official_telephone_number": "870-245-2210",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "AR",
            "license": "P0607039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arkadelphia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.