South Ark Ear Nose & Throat Clinic P a

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

850 Issued in AR

Legal business name

SOUTH ARK EAR NOSE & THROAT CLINIC P A

Doing business as

South Arkansas Surgery Center

Practice address

4310 S Mulberry St
Pine Bluff, AR 71603-7030

Phone

(870) 535-5177

Fax

(870) 535-7878

NPI assigned

Feb 27, 2006

Last updated

Aug 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephen Donald Shorts, MD

Title

President

Phone

(870) 535-5177

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SOUTH ARKANSAS SURGERY CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• South Ark Ear Nose &Throat Clinic P a

  • Otolaryngology Physician
  • Pine Bluff, AR
  • NPI 1356317440

  O20040818000681

  Same enrollment

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219276800000",
    "number": "1962478115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 S MULBERRY ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037030",
            "telephone_number": "870-535-5177",
            "fax_number": "870-535-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 S MULBERRY ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037030",
            "telephone_number": "870-535-5177",
            "fax_number": "870-535-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ARK EAR NOSE & THROAT CLINIC P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-27",
        "last_updated": "2008-08-21",
        "status": "A",
        "authorized_official_last_name": "SHORTS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-535-5177",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AR",
            "license": "850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117713128",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH ARKANSAS SURGERY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul L Smith, M.D.
• Richard Smith
• Sarah Smith, MHPP
• Stephanie Smith, AUD
• Leannah Sneed
• South Ark Ear Nose &Throat Clinic P a
• South Arkansas Cardiology, P.L.L.C.
• South Arkansas Clinic for Women
• South Arkansas Endocrinology
• South Arkansas Gastroenterology Clinic

• Ambulatory Surgical Clinic/Center in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Ambulatory Surgical Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.