NPIMap

Organization Active NPI

Jefferson Regional Medical Center

  • Community/Retail Pharmacy
  • Pine Bluff, AR
National Provider Identifier
1851421861
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR05666 Issued in AR
Legal business name
JEFFERSON REGIONAL MEDICAL CENTER
Practice address
1600 W 40TH Ave
Pine Bluff, AR 71603-6301
Phone
(870) 541-7100
Fax
(870) 541-7499
NPI assigned
Mar 7, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Brian Thomas
Title
President & Ceo
Phone
(870) 541-7214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X AR05666 AR Primary

Addresses

Primary practice location

1600 W 40TH Ave
Pine Bluff, AR 71603-6301

Mailing address

1600 W 40TH Ave
Pine Bluff, AR 71603-6301
Phone (870) 541-7100

Other identifiers 1

IdentifierTypeStateIssuer
100339407MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Regional Med15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1851421861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W 40TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036301",
            "telephone_number": "870-541-7100",
            "fax_number": "870-541-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 40TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036301",
            "telephone_number": "870-541-7100",
            "fax_number": "870-541-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "870-541-7214",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR05666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100339407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.