JEFFERSON COMPREHENSIVE CARE SYSTEM INC (NPI# 1053571711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053571711 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COMPREHENSIVE CARE SYSTEM INC |
| Other Organization Name | JCCSI CROSS OVER |
| Practice Address |
1101 Tennssee Pine Bluff AR 71601 |
| Mailing Address |
Po Box 1285 Pine Bluff AR 71613-1285 |
| Practice Telephone | 8705432380 |
| Practice Fax Number | 8705354716 |
| Mailing Telephone | 8705432380 |
| Mailing Fax Number | 8705354716 |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2008-06-16 |
| Authorized Official Name | MR. LARNELL W DAVIS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8705432380 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 122636741 | 05 |
| Other Name | Type Code |
|---|---|
| JCCSI Cross Over | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023277746 | Jefferson Comprehensive Care System Inc | Dentist | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2008-06-06 |
| 1396904017 | Jefferson Comprehensive Care System Inc | Clinic/Center | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2008-06-06 |
| Street Address |
1101 TENNSSEE |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162863 | Kb's Adult Health Day Care Center | Clinic/Center | 2911 South Market Street, Pine Bluff, AR 71601 | 2020-10-19 |
| 1184244600 | Chelsea Briggs | Prosthetic/Orthotic Supplier | 601 S Main St Apt 514, Pine Bluff, AR 71601 | 2020-04-24 |
| 1407489081 | Katherine Bolden | Clinic/Center | 2911 East Market Street, Pine Bluff, AR 71601 | 2020-02-21 |
| 1851836829 | Rocky Mountain Holdings, LLC | Ambulance | 613b Hangar Row, Pine Bluff, AR 71601 | 2016-12-30 |
| 1316324494 | Nora Elizabeth Horton | Specialist/Technologist | 2003 University Drive, Suite 2, Pine Bluff, Ar, AR 71601 | 2015-04-28 |
| 1780003665 | Sameer R. Shelat | Internal Medicine | 4125, Rhinehart Road, Pine Bluff, AR 71601 | 2014-04-08 |
| 1700150471 | Community Empowerment Council, Inc. | Social Worker | 5830 Hwy 65 South, Pine Bluff, AR 71601 | 2012-02-28 |
| 1922243807 | The Pine Bluff Group, Pllc | Chiropractor | 2102 S. Olive St., Pine Bluff, AR 71601 | 2008-12-08 |
| 1144404799 | The P.a.t. (people Advocating Transition) Center | Counselor | 620 South Laurel, Pine Bluff, AR 71601 | 2007-12-18 |
| 1396946414 | Mickey K. Shell | Psychologist | 3110 Hwy 425 South, Pine Bluff, AR 71601 | 2007-05-29 |
| Find all providers in zip 71601 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154386597 | Jefferson Comprehensive Care System, Inc | Clinic/Center | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962014316 | Healthy Connections, Inc. | Clinic/Center | 1306 W Collin Raye Dr Ste B, De Queen, AR 71832-2502 | 2020-08-18 |
| 1982221065 | Arcare | Clinic/Center | 7300 Dollarway Rd Ste 116, White Hall, AR 71602-3023 | 2020-07-06 |
| 1669099073 | St Francis House Nwa, Inc | Clinic/Center | 1923 W Pickens Road, Pea Ridge, AR 72751 | 2020-07-01 |
| 1427674696 | Arcare | Clinic/Center | 11520 Sr 27, Hector, AR 72843-8710 | 2020-06-23 |
| 1487280384 | Arcare | Clinic/Center | 2805 Mid Cities Dr Ste 1, Bentonville, AR 72712-4291 | 2020-03-23 |
| 1073144028 | Arcare | Clinic/Center | 145 N Curtis Ave, Pea Ridge, AR 72751-3407 | 2020-01-29 |
| 1396383758 | Mainline Health Systems Inc | Clinic/Center | 1012 E Church St Ste B, Warren, AR 71671-3530 | 2019-12-17 |
| 1275177883 | Boston Mountain Rural Health Center, Inc | Clinic/Center | 1201 North Panther Ave # 3, Yellville, AR 72687 | 2019-11-06 |
| 1649814138 | St Francis House Nwa, Inc | Clinic/Center | 2328 Cardinal Drive, Springdale, AR 72764-4469 | 2019-10-29 |
| 1104469832 | Arcare | Clinic/Center | 501 Millwood Cir Ste E, Maumelle, AR 72113-6304 | 2019-10-25 |
| Find all providers with the same taxonomy | ||||
| City | PINE BLUFF |
| Zip Code | 71601 |
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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.