Iti Chito Enterprises Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ITI CHITO ENTERPRISES INC

Doing business as

Lockesburg Family Clinic

Practice address

500 E Collin Raye Dr Ste 2
De Queen, AR 71832-8068

Phone

(870) 642-7257

Fax

(870) 642-5015

NPI assigned

Oct 1, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Rusty Lynn Griffin

Title

Owner

Phone

(501) 765-0275

Specialties & licenses 2

Addresses

Other names 1

• Lockesburg Family Clinic Doing business as

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1912679549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E. COLLIN RAYE DRIVE",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718328054",
            "telephone_number": "870-642-7257",
            "fax_number": "870-642-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E COLLIN RAYE DR STE 2",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718328068",
            "telephone_number": "870-642-7257",
            "fax_number": "870-642-5015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W Main",
            "address_purpose": "LOCATION",
            "city": "Lockesburg",
            "state": "AR",
            "postal_code": "718469621",
            "country_code": "US",
            "telephone_number": "501-765-0275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ITI CHITO ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "RUSTY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-765-0275",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lockesburg Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lockesburg Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan L Hoyt, MD
• Funika Hughes, RN
• Leslie Ann Hunt, RN
• Summer Fawne Irvan
• Iti Chito Enterprises Inc (Lockesburg Family Clinic)
• Sarah Danielle Jackson, OTA
• Misty Dawn Janes
• Kimberly Johnson
• Jonathan L. Hoyt, MD, PA
• Jason Ray Jones, FNP

• Primary Care Clinic/Center in De Queen, AR
• Providers in De Queen, AR by specialty
• Primary Care Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.