BENTON PEDIATRIC CLINIC (NPI# 1497753198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497753198 |
| Entity Type | Organization |
| Organization Name | BENTON PEDIATRIC CLINIC |
| Practice Address |
115 Mcneil St Benton AR 72015-3345 |
| Practice Telephone | 5013150421 |
| Practice Fax Number | 5017786312 |
| Mailing Telephone | 5013150421 |
| Mailing Fax Number | 5017786312 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MARY JEWELL ATKINS (PHYSICIAN) |
| Authorized Official Telephone | 5013150421 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
R2391 | AR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUE CROSS | 50143 | 01 |
| Street Address |
115 MCNEIL ST |
| City | BENTON |
| State | AR |
| Zip Code | 72015-3345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487168308 | Dr Q Pain & Spine Clinic, Pa | Physical Medicine & Rehabilitation | 115 Mcneil St, Benton, AR 72015-3345 | 2017-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790343135 | Justin King | Case Manager/Care Coordinator | 1502 Mary Kay Blv6, Benton, AR 72015 | 2019-05-31 |
| 1790253326 | Seth Alexander Weisheit | Nurse Practitioner | 824 Military Road, Benton, AR 72015 | 2018-11-13 |
| 1396269627 | Abby G Sims | Speech-Language Pathologist | 3391 Peachtree Lane, Benton, AR 72015 | 2017-07-28 |
| 1225551278 | Jessica R Poe | Case Manager/Care Coordinator | 1502 Marykay Blvd, Benton, AR 72015 | 2017-07-21 |
| 1003357997 | Jamaal Langston | Case Manager/Care Coordinator | 1502 Mark Kay Blvd, Benton, AR 72015 | 2017-03-13 |
| 1881138550 | Shannon Gachot-ridgley | Counselor | 205 South Street Suite 3, Benton, AR 72015 | 2016-12-14 |
| 1295104578 | Excel Health of Haskell, Pllc | Clinical Nurse Specialist | 6029 Us Hwy 67, Haskell, AR 72015 | 2015-09-17 |
| 1528464054 | Kacey Jo Kiker | Nurse Practitioner | 620 W South St, Benton, AR 72015 | 2014-11-11 |
| 1700218252 | Jamie Brunt | Licensed Practical Nurse | 1718 Old Hot Springs Rd, Benton, AR 72015 | 2013-08-07 |
| 1760738942 | Kari J Richards | Physical Therapist | 5701 Springhill Rd, Bryant, AR 72015 | 2012-07-25 |
| Find all providers in zip 72015 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891357455 | Pinnacle Health Partners Pllc | Clinic/Center | 17447 Highway 9, Benton, AR 72019-9223 | 2019-07-03 |
| 1811385347 | David F Szoke Md | Clinic/Center | 905 W Washington St, Benton, IL 62812-1649 | 2015-01-06 |
| 1831418730 | Franklin Hospital District | Clinic/Center | 320 N Main St, Suite A, Benton, IL 62812-1313 | 2010-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275134603 | Sheridan Family Clinic, Pllc | Clinic/Center | 109 W Pine St Ste A, Sheridan, AR 72150-2443 | 2020-11-03 |
| 1346848850 | Arkansas Premier Medical Clinic | Clinic/Center | 22461 I 30 Ste 402, Bryant, AR 72022-2383 | 2020-10-16 |
| 1659985570 | Premise Health of Arkansas Medical P A | Clinic/Center | 3307 N 2nd St, Rogers, AR 72756-0001 | 2020-09-08 |
| 1497376321 | Magnolia Regional Health System Inc | Clinic/Center | 1010 N Dudney Rd Ste C, Magnolia, AR 71753-2651 | 2020-05-01 |
| 1548892433 | Genesis Health and Wellness, Pllc | Clinic/Center | 110 N Hendrix St, Imboden, AR 72434-9077 | 2020-02-07 |
| 1700430386 | Kidspiration of Marion County | Clinic/Center | 81 Development Dr, Yellville, AR 72687-0662 | 2019-07-31 |
| 1083273007 | Diane K Bodemann Md Ltd | Clinic/Center | 256 Grandstaff Dr, Hot Springs, AR 71913-8789 | 2019-06-12 |
| 1265098552 | Community Family Medical LLC | Clinic/Center | 1139 North Highway 77, Marion, AR 72364-9027 | 2019-05-13 |
| 1174187132 | Arcare | Clinic/Center | 3800 Rogers Ave Ste 6, Fort Smith, AR 72903-3075 | 2019-04-25 |
| 1033773932 | Arcare | Clinic/Center | 1801 Central Ave Ste F, Hot Springs, AR 71901-6800 | 2019-04-25 |
| 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.