NPIMap

Organization Active NPI

Jefferson Hospital Association, Inc.

  • Pediatric Adolescent Medicine Physician
  • Pine Bluff, AR
National Provider Identifier
1881162469
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
JEFFERSON HOSPITAL ASSOCIATION, INC.
Practice address
1420 W 43Rd Ave
Pine Bluff, AR 71603-7010
Phone
(870) 534-6210
Fax
(870) 534-8620
NPI assigned
Nov 13, 2018
Last updated
Nov 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Authorized official

Name
Bryan Jackson
Title
Cfo
Phone
(870) 541-7141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X Primary

Addresses

Primary practice location

1420 W 43Rd Ave
Pine Bluff, AR 71603-7010

Mailing address

PO Box 2650
Pine Bluff, AR 71613-2650
Phone (870) 541-7235

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Hospital Assn Inc15 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

Practitioners & affiliated clinicians

Practitioners 3

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": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1881162469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2650",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716132650",
            "telephone_number": "870-541-7235",
            "fax_number": "870-541-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W 43RD AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037010",
            "telephone_number": "870-534-6210",
            "fax_number": "870-534-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON HOSPITAL ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-541-7141"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 13, 2018; 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.