NPIMap

Organization Active NPI

Crittenden Hospital Association

Doing business as Mid-South Pediatrics

  • Pediatrics Physician
  • Marion, AR
National Provider Identifier
1982661500
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CRITTENDEN HOSPITAL ASSOCIATION
Doing business as
Mid-South Pediatrics
Practice address
2921 Hwy 77
Suite 20
Marion, AR 72364-2367
Phone
(870) 739-5311
Fax
(870) 739-5542
NPI assigned
Apr 27, 2006
Last updated
Dec 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Authorized official

Name
Cheryl Prince
Title
Clinics Administrator
Phone
(870) 735-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

2921 Hwy 77
Suite 20
Marion, AR 72364-2367

Mailing address

2921 Hwy 77
Suite 20
Marion, AR 72364-2367
Phone (870) 739-5311

Other identifiers 1

IdentifierTypeStateIssuer
133764002MedicaidAR

Other names 1

  • Mid-South Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Riverside Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1982661500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 HWY 77",
            "address_2": "SUITE 20",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642367",
            "telephone_number": "870-739-5311",
            "fax_number": "870-739-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 HWY 77",
            "address_2": "SUITE 20",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642367",
            "telephone_number": "870-739-5311",
            "fax_number": "870-739-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRITTENDEN HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CLINICS ADMINISTRATOR",
        "authorized_official_telephone_number": "870-735-1500"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133764002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-South Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.