NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC (NPI# 1790016418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790016418 |
| Entity Type | Organization |
| Organization Name | NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC |
| Other Organization Name | NEA BAPTIST CLINIC IMAGING CENTER |
| Practice Address |
3100 Apache Dr Suite C1 Jonesboro AR 72401-7404 |
| Mailing Address |
350 N Humphreys Blvd Memphis TN 38120-2177 |
| Practice Telephone | 8709345102 |
| Practice Fax Number | 8709323608 |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | MR. GREGORY M DUCKETT (SR VP/ CLO) |
| Authorized Official Telephone | 9012275233 |
| Is Organization Subpart | Y |
| Parent Organization Name | BAPTIST MEMORIAL HEALTH CARE CORP. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| NEA Baptist Clinic Imaging Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982935060 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 1007 Windover, Ste B, Jonesboro, AR 72401 | 2010-01-29 |
| 1306177456 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 616 W Keiser, Osceola, AR 72370 | 2010-01-28 |
| 1639400807 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 51 Choctaw Trce, Cherokee Village, AR 72529-2702 | 2010-01-27 |
| 1346661956 | Northeast Arkansas Clinic Charitable Foundation, Inc | Clinic/Center | 4802 E. Johnson Avenue, Jonesboro, AR 72401 | 2013-12-27 |
| 1518299577 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 3, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1881926848 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 1, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1326370388 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite A, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1972835924 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 4, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1245562206 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 2, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1700117892 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 1007 Windover Rd, Suite A, Jonesboro, AR 72401-6007 | 2010-01-29 |
| Street Address |
3100 APACHE DR SUITE C1 |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-7404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023074002 | Jeff Mullen | Radiology | 3100 Apache Dr, Suite C1, Jonesboro, AR 72401-7404 | 2006-04-26 |
| 1982170908 | Amanda Lashay Mathis | Licensed Practical Nurse | 3100 Apache Dr, Jonesboro, AR 72401-7404 | 2018-10-17 |
| 1700378015 | Kimberly Ann Potter | Developmental Therapist | 3100 Apache Dr, Jonesboro, AR 72401-7404 | 2018-06-01 |
| 1811485295 | Shawna Mann | Licensed Practical Nurse | 3100 Apache Dr, Jonesboro, AR 72401-7404 | 2018-05-01 |
| 1164957080 | First Step Arkansas, LLC | Early Intervention Provider Agency | 3100 Apache Dr, Jonesboro, AR 72401-7404 | 2017-04-28 |
| 1518299577 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 3, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1881926848 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 1, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1326370388 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite A, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1972835924 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 4, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1245562206 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 2, Jonesboro, AR 72401-7404 | 2010-02-02 |
| Find all providers in the same location | ||||
| 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 | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487778593 | Us Radiology Partners of Texas Inc | Clinic/Center | 4201 Clubhouse Dr, Jonesboro, AR 72401-8078 | 2007-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740527001 | North Lr Medical Imaging LLC | Clinic/Center | 3320 Springhill Dr, Suite 200, N Little Rock, AR 72117-2922 | 2013-01-07 |
| 1760660351 | Med Imaging of Arkansas, Pllc | Clinic/Center | 6948 Alcoa Rd, Suite G, Benton, AR 72015-9726 | 2008-02-05 |
| 1073719423 | South Arkansas Open Mri LLC | Clinic/Center | 2401 W Hillsboro St, El Dorado, AR 71730-6815 | 2007-06-22 |
| 1568506715 | Arkansas Mri Services LLC | Clinic/Center | 1703 Phyllis St, Suite 101, Bentonville, AR 72712-7094 | 2007-02-19 |
| 1467492009 | Cabot Imaging Center, LLC | Clinic/Center | 2039 West Main Street, Suite A, Cabot, AR 72023 | 2006-06-08 |
| 1588265003 | Brittany Barber, Pllc | Clinic/Center | 1357 W Collin Raye Dr, De Queen, AR 71832-2946 | 2020-11-02 |
| 1013522127 | Sarc By Hsh Asc Pine Bluff | Clinic/Center | 7200 S Hazel St, Pine Bluff, AR 71603-7836 | 2020-09-15 |
| 1568086940 | Lansdell Enterprise Corp | Clinic/Center | 500 E Collin Raye Dr, De Queen, AR 71832-8048 | 2020-06-02 |
| 1649715681 | Chaffee Diagnostics LLC | Clinic/Center | 11300 Roberts Blvd, Fort Smith, AR 72916-6027 | 2016-12-29 |
| 1457706376 | 360 Imaging LLC | Clinic/Center | 3320 Springhill Dr, North Little Rock, AR 72117-2922 | 2016-04-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
| 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.