NPIMap

Organization Active NPI

Arkansas Children's Hospital

Doing business as Arkansas Children's Hospital Pine Bluff Clinic

  • Pediatrics Physician
  • Pine Bluff, AR
National Provider Identifier
1972189694
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ARKANSAS CHILDREN'S HOSPITAL
Doing business as
Arkansas Children's Hospital Pine Bluff Clinic
Practice address
1500 West 42ND Avenue
Pine Bluff, AR 71603-7006
Phone
(501) 364-2526
Fax
(501) 364-2438
NPI assigned
Mar 23, 2021
Last updated
Mar 23, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ARKANSAS CHILDREN'S HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Authorized official

Name
Sheryl Phillips
Title
Sr. Billing/Systems Manager
Phone
(501) 364-2526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1500 West 42ND Avenue
Pine Bluff, AR 71603-7006

Mailing address

1 Childrens Way # 664
Little Rock, AR 72202-3500
Phone (501) 364-2526

Other names 1

  • Arkansas Children's Hospital Pine Bluff Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dennis Developmental Ce15 organizations share this tax ID, including this one
Part of
Dennis Developmental Ce

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1972189694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 664",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-2526",
            "fax_number": "501-364-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WEST 42ND AVENUE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037006",
            "telephone_number": "501-364-2526",
            "fax_number": "501-364-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS CHILDREN'S HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARKANSAS CHILDREN'S HOSPITAL",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_title_or_position": "SR. BILLING/SYSTEMS MANAGER",
        "authorized_official_telephone_number": "501-364-2526"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arkansas Children's Hospital Pine Bluff Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 23, 2021; 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.