Richard D Justiss, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C5209 Issued in AR

Practice address

1222 W 42ND Ave
Pine Bluff, AR 71603-7109

Phone

(870) 535-1819

Fax

(870) 534-3340

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Arkansas College of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Arkansas for Medical SciencesGroup PAC ID 4082528955, 1,159 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016
• Jefferson Regional Medical Center Hospital, Pine Bluff, AR, CCN 040071

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • Pine Bluff, AR
  • NPI 1831144120
  Medicare reassignment Care Compare group NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jefferson Hospital Association Inc

  dba Jefferson Regional Medical Center

  • General Acute Care Hospital
  • Pine Bluff, AR
  • NPI 1710931985
  Care Compare affiliation
• University of Arkansas for Medical Sciences

  dba The University Hospital of Arkansas

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1477549756
  Care Compare affiliation

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1982631313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 S MULBERRY ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037000",
            "telephone_number": "870-541-6008",
            "fax_number": "870-541-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 W 42ND AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037109",
            "telephone_number": "870-535-1819",
            "fax_number": "870-534-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTISS",
        "first_name": "RICHARD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C5209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106370001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tameka Deacquanita Jones
• Tonisha Jones, M.A., MHPP
• Wanda F Jones, R.N.
• Biji Jose, OT
• Heidi Nicole Judkins, M.S. CF-SLP
• Deidra Sade Jynes
• Lillian Jynes, FNP
• Noormahal Kabani, M.D.
• Larisa Kachowski, MD
• Carla Christine Karlson

• Family Medicine Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.