NPIMap

Organization Active NPI

Physician's Management Group

  • Intellectual & Developmental Disabilities Psychologist
  • Jacksonville, AR
National Provider Identifier
1871756437
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
C5129 Issued in AR
Legal business name
PHYSICIAN'S MANAGEMENT GROUP
Practice address
2520 W Main St
Jacksonville, AR 72076-4214
Phone
(501) 982-0528
Fax
(501) 985-7777
NPI assigned
Jul 3, 2008
Last updated
Jul 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Dr. Robert Farrell, MDNPI 1669494092
Title
Ceo
Phone
(501) 663-4204

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
Intellectual & Developmental Disabilities Psychologist 103TM1800X C5129 AR Primary

Addresses

Primary practice location

2520 W Main St
Jacksonville, AR 72076-4214

Mailing address

501 N Elm St
Little Rock, AR 72205-3927
Phone (501) 663-4204

National Provider Directory

National Provider Directory
Tax ID family
Physician's Management Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1871756437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N ELM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053927",
            "telephone_number": "501-663-4204",
            "fax_number": "501-663-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 W MAIN ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720764214",
            "telephone_number": "501-982-0528",
            "fax_number": "501-985-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN'S MANAGEMENT GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-663-4204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "AR",
            "license": "C5129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.