NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC. (NPI# 1033491519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033491519 |
| Entity Type | Organization |
| Organization Name | NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC. |
| Other Organization Name | NEA BAPTIST CLINIC DIALYSIS CENTER/HILLTOP |
| Practice Address |
4909 East Johnson Ave. Jonesboro AR 72401 |
| Mailing Address |
350 N Humphreys Blvd Memphis TN 38120-2177 |
| Practice Telephone | 8703363372 |
| Practice Fax Number | 8709343658 |
| Mailing Telephone | 9012275233 |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | GREGORY M DUCKETT (SR VP/ CLO) |
| Authorized Official Telephone | 9012275233 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 200341134 | 05 | |
| AR | BCBS | 12577 | 01 |
| Other Name | Type Code |
|---|---|
| NEA Baptist Clinic Dialysis Center/Hilltop | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528399755 | Northeast Arkansas Clinic Charitable Foundation, Inc. | Clinic/Center | 1118 Windover, Jonesboro, AR 72401-6155 | 2010-01-28 |
| 1801127030 | Northeast Arkansas Clinic Charitable Foundation, Inc. | Clinical Medical Laboratory | 4802 E. Johnson Avenue, Jonesboro, AR 72401 | 2010-01-28 |
| 1932503372 | Northeast Arkansas Clinic Charitable Foundation, Inc. | Durable Medical Equipment & Medical Supplies | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 | 2014-10-14 |
| 1912328428 | Northeast Arkansas Clinic Charitable Foundation, Inc. | Clinic/Center | 4808 E Johnson Ave, Jonesboro, AR 72401-8413 | 2013-12-31 |
| 1992036032 | Northeast Arkansas Clinic Charitable Foundation, Inc. | Anesthesiology | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 | 2010-01-28 |
| 1861721839 | Northeast Arkansas Clinic Charitable Foundation, Inc. | Clinic/Center | 4802 E Johnson Ave, Jonesboro, AR 72401-8413 | 2009-12-21 |
| Street Address |
4909 EAST JOHNSON AVE. |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962946350 | Total Renal Care Inc | Clinic/Center | 6540 Tara Blvd, Ste 200, Jonesboro, GA 30236-1228 | 2016-12-05 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| 1568885812 | Bio-medical Applications of Georgia, Inc. | Clinic/Center | 2450 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2014-01-22 |
| 1851352991 | Northeast Arkansas Clinic, P.a. | Clinic/Center | 3005 Middlefield Dr, Jonesboro, AR 72401-7438 | 2006-03-29 |
| 1316916257 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 129 King St, Jonesboro, GA 30236-3656 | 2006-03-14 |
| 1447581673 | Northeast Arkansas Clinic Charitable Foundation, Inc | Clinic/Center | 3005 Middlefield Dr, Jonesboro, AR 72401-7438 | 2010-01-28 |
| 1134141906 | St Bernards Hospital Inc | Clinic/Center | 225 E Washington Ave, Jonesboro, AR 72401-3111 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092597 | Fort Smith Regional Dialysis Center, LLC | Clinic/Center | 256 Northridge Drive E, Van Buren, AR 72956 | 2020-08-06 |
| 1073010518 | Toltec Dialysis LLC | Clinic/Center | 2630 Donaghey Ave, Conway, AR 72032-0000 | 2018-04-11 |
| 1588102610 | Matheson Dialysis LLC | Clinic/Center | 9022 Landers Rd Ste E, North Little Rock, AR 72117-1599 | 2017-02-09 |
| 1871031211 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 115 E Peddicord St, Dermott, AR 71638-2314 | 2017-02-06 |
| 1821455494 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 505 Saint Mary St, Lake Village, AR 71653-1722 | 2016-01-27 |
| 1912399601 | Ozark Dialysis LLC | Clinic/Center | 404 Camp Rd, Pocahontas, AR 72455-1487 | 2015-03-04 |
| 1447640917 | Fidelity Home Dialysis Corporation | Clinic/Center | 9421 W Markham St, Little Rock, AR 72205-2240 | 2015-02-04 |
| 1386053296 | Arkansas Staff Assisted Hemodialysis,inc | Clinic/Center | 321 Terry Pond Cv, White Hall, AR 71602-8212 | 2014-08-05 |
| 1609291202 | Little Rock Renal Services LLC | Clinic/Center | 1910 John Barrow Rd, Little Rock, AR 72204-1448 | 2014-02-19 |
| 1396178471 | Renal Treatment Centers - Southeast Lp | Clinic/Center | 6115 Baseline Rd, Ste 100, Little Rock, AR 72209 | 2013-08-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.