PLASTIC SURGERY ASSOCIATES OF NORTHEAST ARKANSAS, P.A. (NPI# 1396809711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396809711 |
| Entity Type | Organization |
| Organization Name | PLASTIC SURGERY ASSOCIATES OF NORTHEAST ARKANSAS, P.A. |
| Practice Address |
1003 Windover Rd Jonesboro AR 72401-6007 |
| Practice Telephone | 8709350861 |
| Practice Fax Number | 8709725241 |
| Mailing Telephone | 8709350861 |
| Mailing Fax Number | 8709725241 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2010-10-14 |
| Authorized Official Name | DR. CONNIE L. HIERS (OWNER) |
| Authorized Official Telephone | 8709350861 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | R3542 | AR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 118638002 | 05 | |
| AR | BCBS CLINIC PROVIDER | 5B105 | 01 |
| Street Address |
1003 WINDOVER RD |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-6007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013952365 | Connie L Hiers | Plastic Surgery | 1003 Windover Rd, Jonesboro, AR 72401-6007 | 2006-06-19 |
| 1184189219 | Callie Graves | Physician Assistant | 1003 Windover Rd, Jonesboro, AR 72401-6007 | 2019-02-03 |
| 1679029227 | Nancy Pemberton | Nurse Practitioner | 1003 Windover Rd, Jonesboro, AR 72401 | 2016-09-01 |
| 1770932550 | Sills Dermatology, Pllc | Dermatology | 1003 Windover Rd, Jonesboro, AR 72401-6007 | 2016-06-12 |
| 1316147911 | Lara Christine Bulkley | Nurse Anesthetist, Certified Registered | 1003 Windover Rd, Jonesboro, AR 72401-6007 | 2007-07-20 |
| 1952326951 | Adam Ashley Sills | Dermatology | 1003 Windover Rd, Jonesboro, AR 72401-6007 | 2006-07-12 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699227876 | Shirley Ann Morton | Specialist | 188 North Ave, Jonesboro, GA 30236-3215 | 2016-11-03 |
| 1306286323 | Eric Chandler Treadway | Specialist | 1699 Stadium Blvd, Suite H, Jonesboro, AR 72401 | 2013-07-05 |
| 1679819312 | Ethel L High | Specialist | 9285 Carnes Estates Dr, Jonesboro, GA 30236-6275 | 2012-12-28 |
| 1538438254 | Chenell Denise Williams | Specialist | 308 Wilburn St, Jonesboro, GA 30236-3637 | 2011-12-26 |
| 1134406341 | Ashley Brooke Thrasher | Specialist | 2105 E Aggie Rd, Arkansas State University-hpess, Jonesboro, AR 72401 | 2011-11-16 |
| 1679856967 | Amy Forester | Specialist | 806 Glendale, Jonesboro, AR 72401 | 2011-09-22 |
| 1891000550 | Sunil Gera M.d.p.a. | Specialist | 2601 Southwest Sq, Jonesboro, AR 72401-5969 | 2010-08-18 |
| 1922338292 | Nataki Burke | Specialist | 10305 Misty Ridge Dr, Jonesboro, GA 30238-8027 | 2010-01-07 |
| 1215176466 | Visa Lahang Avance | Specialist | 1656 W Matthews Ave Apt 5, Jonesboro, AR 72401-3311 | 2009-02-11 |
| 1538297395 | Michael Devon Brown | Specialist | 1710 Battlecreek Village Dr, Jonesboro, GA 30236-8527 | 2007-03-01 |
| Find all providers in JONESBORO | ||||
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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.