NPIMap

Organization Active NPI

Gray-Millenbaugh Practitioner Healthcare, LLC

  • Nursing Care Agency
  • Pine Bluff, AR
National Provider Identifier
1962883520
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
A002944 Issued in AR
Legal business name
GRAY-MILLENBAUGH PRACTITIONER HEALTHCARE, LLC
Practice address
3801 Camden Rd
Chapel Village 1 Suite 12
Pine Bluff, AR 71603-4612
Phone
(870) 534-4847
Fax
(870) 534-4884
NPI assigned
Jun 9, 2015
Last updated
Jun 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Authorized official

Name
Diana Gray Millenbaugh, MSN, APRN, BCNPI 1033405600
Title
Owner
Phone
(870) 329-4202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X A002944 AR Primary
Emergency Care Clinic/Center 261QE0002X A002944 AR
Health Service Clinic/Center 261QH0100X A002944 AR
Primary Care Clinic/Center 261QP2300X A002944 AR

Addresses

Primary practice location

3801 Camden Rd
Chapel Village 1 Suite 12
Pine Bluff, AR 71603-4612

Mailing address

3801 Camden Rd
Chapel Village 1 Suite 12
Pine Bluff, AR 71603-4612
Phone (870) 534-4847

National Provider Directory

National Provider Directory

Locations

3801 Chapel Vlg
Ste 12
Pine Bluff, AR 71603
Phone (870) 534-4847

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": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1962883520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 CAMDEN RD",
            "address_2": "CHAPEL VILLAGE 1 SUITE 12",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034612",
            "telephone_number": "870-534-4847",
            "fax_number": "870-534-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 CAMDEN RD",
            "address_2": "CHAPEL VILLAGE 1 SUITE 12",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034612",
            "telephone_number": "870-534-4847",
            "fax_number": "870-534-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAY-MILLENBAUGH PRACTITIONER HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "MILLENBAUGH",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "GRAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-329-4202",
        "authorized_official_credential": "MSN, APRN, BC"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "AR",
            "license": "A002944",
            "primary": true
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "AR",
            "license": "A002944",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AR",
            "license": "A002944",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": "A002944",
            "primary": false
        }
    ],
    "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 Jun 9, 2015; 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.