LIDWINA WANGSADIPURA POWERS (NPI# 1124355623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124355623 |
| Entity Type | Individual |
| Full Name | LIDWINA WANGSADIPURA POWERS |
| Credential | PA-C |
| Practice Address |
416 E Washington Ave Jonesboro AR 72401 |
| Mailing Address |
Po Box 497 Augusta AR 72006-0497 |
| Practice Telephone | 8703335476 |
| Practice Fax Number | 8703335475 |
| Mailing Telephone | 8703472534 |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2018-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA-753 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA20529 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 222656795 | 05 |
| Street Address |
416 E WASHINGTON AVE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710964226 | Ronald C Only | Family Medicine | 416 E Washington Ave, Jonesboro, AR 72401-3108 | 2005-12-27 |
| 1013522408 | Caitlin Rae Cothern | Dietitian, Registered | 416 E Washington Ave, Jonesboro, AR 72401-3108 | 2020-09-11 |
| 1740830421 | Abigail Sarah Mcnatt | Dietitian, Registered | 416 E Washington Ave, Jonesboro, AR 72401-3108 | 2019-09-16 |
| 1962989871 | Andrew R Smith | Nurse Practitioner | 416 E Washington Ave, Jonesboro, AR 72401-3108 | 2018-07-24 |
| 1154776532 | Arcare | Clinic/Center | 416 E Washington Ave, Jonesboro, AR 72401-3108 | 2016-05-04 |
| 1083945166 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 416 E Washington Ave, Suite B, Jonesboro, AR 72401-3108 | 2010-01-29 |
| 1295966364 | Natasha Lynn Woods | Social Worker | 416 E Washington Ave, Jonesboro, AR 72401-3108 | 2009-08-06 |
| 1184885253 | Adrienne Estelle Loftis | Obstetrics & Gynecology | 416 E Washington Ave, Jonesboro, AR 72401-3108 | 2008-06-21 |
| 1174799258 | Andrea Leigh Read | Internal Medicine | 416 E Washington Ave, Jonesboro, AR 72401-3108 | 2008-05-07 |
| 1780706473 | Allison Melissa Mcarthur | Social Worker | 416 E Washington Ave, Jonesboro, AR 72401-3108 | 2007-04-04 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487944583 | Crystal G Watson | Physician Assistant | 3100 Apache, Ste. A, Jonesboro, AR 72401-3125 | 2011-04-11 |
| 1932740339 | Taylor Paige Barton | Physician Assistant | 1416 E Matthews Ave Ste 200, Jonesboro, AR 72401-4362 | 2019-10-07 |
| 1376002766 | Arielle Nast | Physician Assistant | 1416 E Matthews Ave Ste 200, Jonesboro, AR 72401-4362 | 2019-03-15 |
| 1184189219 | Callie Graves | Physician Assistant | 1003 Windover Rd, Jonesboro, AR 72401-6007 | 2019-02-03 |
| 1801350285 | Brandy N Herrington | Physician Assistant | 4802 E Johnson Ave, Jonesboro, AR 72401-8413 | 2019-01-30 |
| 1093244220 | Megan Deanne Griffin | Physician Assistant | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2017-06-10 |
| 1053843631 | Mary R Hobbs | Physician Assistant | 1416 E Matthews Ave, Jonesboro, AR 72401-4362 | 2017-04-01 |
| 1821536772 | Danielle Bruggemann | Physician Assistant | 4802 E Johnson Ave, Jonesboro, AR 72401-8413 | 2017-02-10 |
| 1497103626 | Aaron Hathcock | Physician Assistant | 225 E Jackson Ave, Jonesboro, AR 72401-3119 | 2016-05-27 |
| 1225498074 | Callie Poole | Physician Assistant | 300 Carson St, Jonesboro, AR 72401-3104 | 2016-03-07 |
| Find all providers in JONESBORO | ||||
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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.