NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC. (NPI# 1861721839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861721839 |
| Entity Type | Organization |
| Organization Name | NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC. |
| Other Organization Name | NEA BAPTIST CLINIC |
| Practice Address |
4802 E Johnson Ave Jonesboro AR 72401-8413 |
| Mailing Address |
350 N Humphreys Blvd Memphis TN 38120-2177 |
| Practice Telephone | 8709368000 |
| Practice Fax Number | 8709360100 |
| Mailing Fax Number | 8709360100 |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | 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 | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| 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 |
| 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 |
| Street Address |
4802 E JOHNSON AVE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-8413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699779686 | Paul S Levy | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4802 E Johnson Ave, Jonesboro, AR 72401 | 2005-06-08 |
| 1316546138 | Emily M Allen | Nurse Practitioner | 4802 E Johnson Ave, Jonesboro, AR 72405-8413 | 2020-10-22 |
| 1699387274 | Sarah E Dulaney | Clinical Nurse Specialist | 4802 E Johnson Ave, Jonesboro, AR 72405-8413 | 2020-08-17 |
| 1154965036 | Danny Lee Ricker | Nurse Practitioner | 4802 E Johnson Ave, Jonesboro, AR 72405-8413 | 2019-11-04 |
| 1679117659 | Ryan Scott Anderson | Clinical Nurse Specialist | 4802 E Johnson Ave, Jonesboro, AR 72405-8413 | 2019-11-01 |
| 1366086787 | Jennifer L Turnbow | Nurse Practitioner | 4802 E Johnson Ave, Jonesboro, AR 72405-8413 | 2019-10-29 |
| 1487201703 | Mary Daniel Johnson | Dietitian, Registered | 4802 E Johnson Ave, Jonesboro, AR 72405-8413 | 2019-08-21 |
| 1285288357 | Kellye P Brown | Nurse Practitioner | 4802 E Johnson Ave, Jonesboro, AR 72405-8413 | 2019-07-28 |
| 1801448592 | Helen F Williams | Nurse Practitioner | 4802 E Johnson Ave, Jonesboro, AR 72405-8413 | 2019-07-12 |
| 1801350285 | Brandy N Herrington | Physician Assistant | 4802 E Johnson Ave, Jonesboro, AR 72401-8413 | 2019-01-30 |
| 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 | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376517177 | Northeast Arkansas Clinic, Pa | Clinic/Center | 1835 Grant Ave., Jonesboro, AR 72401 | 2006-02-16 |
| 1699221648 | Northside Hospital Inc | Clinic/Center | 7823 Spivey Station Blvd, Jonesboro, GA 30236-2886 | 2016-08-30 |
| 1346661956 | Northeast Arkansas Clinic Charitable Foundation, Inc | Clinic/Center | 4802 E. Johnson Avenue, Jonesboro, AR 72401 | 2013-12-27 |
| 1386699353 | Baptist Memorial Hospital-jonesboro Inc | Clinic/Center | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 | 2006-05-24 |
| 1518910215 | Benchmark Physical Therapy, Inc | Clinic/Center | 7130 Mount Zion Blvd, Suite 9, Jonesboro, GA 30236-2566 | 2006-05-17 |
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|---|---|---|---|---|
| 1457904005 | White River Health System, Inc. | Clinic/Center | 195 Hospital Dr Ste C, Cherokee Village, AR 72529-7330 | 2019-07-23 |
| 1023677168 | Apollo Medical Center Pllc | Clinic/Center | 111 Cordoba Center Dr, Hot Springs Village, AR 71909-4093 | 2019-06-12 |
| 1265905293 | Joshua Franklin Barnes | Clinic/Center | 145 Bison Trl, Hot Springs, AR 71913-8329 | 2019-01-02 |
| 1558841239 | Premise Health of Arkansas Medical P A | Clinic/Center | 408 N 8th St Ste A, Rogers, AR 72756-3740 | 2018-08-21 |
| 1942795141 | Loah Community Development Center | Clinic/Center | 110 Ponderosa Ln, Suite C, Hot Springs Village, AR 71909 | 2018-06-29 |
| 1487149985 | Healthcare Express, LLP | Clinic/Center | 1021 W. Collin Raye Dr., Dequeen, AR 71832 | 2018-06-27 |
| 1043714694 | Healthcare Express, LLP | Clinic/Center | 1554 Country Club Road, Sherwood, AR 72120 | 2018-03-20 |
| 1831582758 | Mid- South Rheumatology & Internal Medicine | Clinic/Center | 612 River Oaks Dr, Marion, AR 72364-9048 | 2015-03-17 |
| 1972929230 | Nine Two Six, Inc | Clinic/Center | 2577 N Lowell Rd, Springdale, AR 72764-1818 | 2014-03-11 |
| 1326389404 | Mercy Health Northwest Arkansas Communities | Clinic/Center | 3333 Pinnacle Hills Pkwy Ste 300-a, Rogers, AR 72758-9100 | 2013-03-14 |
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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.