NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC. (NPI# 1801127030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801127030 |
| Entity Type | Organization |
| Organization Name | NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC. |
| Other Organization Name | NEA BAPTIST CLINIC |
| Practice Address |
4802 E. Johnson Avenue Jonesboro AR 72401 |
| Mailing Address |
350 N Humphreys Blvd Memphis TN 38120-2177 |
| Practice Telephone | 8709368000 |
| Practice Fax Number | 8709323608 |
| Mailing Telephone | 9012275233 |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | GREGORY DUCKETT (SR VP/ CLO) |
| Authorized Official Telephone | 9012275233 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| NEA Baptist Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033491519 | Northeast Arkansas Clinic Charitable Foundation, Inc. | Clinic/Center | 4909 East Johnson Ave., Jonesboro, AR 72401 | 2011-09-12 |
| 1528399755 | Northeast Arkansas Clinic Charitable Foundation, Inc. | Clinic/Center | 1118 Windover, Jonesboro, AR 72401-6155 | 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 |
4802 E. JOHNSON AVENUE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346661956 | Northeast Arkansas Clinic Charitable Foundation, Inc | Clinic/Center | 4802 E. Johnson Avenue, Jonesboro, AR 72401 | 2013-12-27 |
| 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 | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| 1043448392 | Covenant Medical Diagnostics | Clinical Medical Laboratory | 2759 Mount Zion Pkwy, Suite A/b, Jonesboro, GA 30236-2568 | 2009-06-25 |
| 1710129465 | Michael O Oyerinde | Clinical Medical Laboratory | 2759 Mount Zion Pkwy, Suite A/b, Jonesboro, GA 30236-2568 | 2009-03-26 |
| 1306009931 | Kaiser Foundation Health Plan of Georgia Inc. | Clinical Medical Laboratory | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2008-07-03 |
| 1992992085 | Northeast Ark Int Med C | Clinical Medical Laboratory | 311 E Matthews Ave, Jonesboro, AR 72401 | 2007-10-02 |
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|---|---|---|---|---|
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| 1558929224 | Ar Journey Lab LLC | Clinical Medical Laboratory | 1705 Central Ave, Hot Springs, AR 71901-6850 | 2019-05-29 |
| 1629632203 | Exacta Laboratory Systems, LLC | Clinical Medical Laboratory | 2400 E Kiehl Ave, Sherwood, AR 72120-3136 | 2019-04-29 |
| 1730658279 | Natural State Laboratories, LLC | Clinical Medical Laboratory | 4851 Northshore Ln, North Little Rock, AR 72118-5329 | 2018-11-14 |
| 1275001851 | Cquentia Arkansas Lab LLC | Clinical Medical Laboratory | 112 W Center St Ste 504, Fayetteville, AR 72701-6073 | 2018-11-13 |
| 1568949436 | Stateline Medical Ar LLC | Clinical Medical Laboratory | 12204 W Highway 62, Farmington, AR 72730-9560 | 2018-07-24 |
| 1154822567 | Ares Laboratory LLC | Clinical Medical Laboratory | 14524 Cantrell Rd Ste 100b, Little Rock, AR 72223-4700 | 2018-02-22 |
| 1033638069 | Bds Healthcare LLC | Clinical Medical Laboratory | 1311 Fort St Ste M, Barling, AR 72923-2045 | 2017-09-11 |
| 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.