CHILDREN'S CLINIC, P.A. (NPI# 1255395950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255395950 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S CLINIC, P.A. |
| Practice Address |
1420 W 43rd Ave Pine Bluff AR 71603-7010 |
| Practice Telephone | 8705346210 |
| Practice Fax Number | 8705348620 |
| Mailing Telephone | 8705346210 |
| Mailing Fax Number | 8705348620 |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | HORACE L GREEN (PHYSICIAN) |
| Authorized Official Telephone | 8705346210 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ARKANSAS BLUE CROSS | 56703 | 01 |
| Street Address |
1420 W 43RD AVE |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-7010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093779787 | Lloyene Bruce-reid | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2006-04-12 |
| 1881162469 | Jefferson Hospital Association, Inc. | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2018-11-13 |
| 1275935363 | Sevilay Dalabih | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2014-09-19 |
| 1134183395 | Joann B Mays | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2006-04-14 |
| 1093779324 | Horace L Green | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2006-04-13 |
| 1699739375 | Susan G Mcgeorge | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2006-04-12 |
| 1407810187 | Joyce V Fletcher | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2006-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578619177 | John Alonzo Flowers Sr. | Pediatrics | 316 W 5th Ave, Pine Bluff, AR 71601-4214 | 2007-01-26 |
| 1093779787 | Lloyene Bruce-reid | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2006-04-12 |
| 1881162469 | Jefferson Hospital Association, Inc. | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2018-11-13 |
| 1164604930 | Flowers Pediatraic Clinic | Pediatrics | 316 W 5th Ave, Pine Bluff, AR 71601-4214 | 2007-12-03 |
| 1134183395 | Joann B Mays | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2006-04-14 |
| 1093779324 | Horace L Green | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2006-04-13 |
| 1699739375 | Susan G Mcgeorge | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2006-04-12 |
| 1407810187 | Joyce V Fletcher | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2006-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689182412 | Saveritt Pediatrics Pllc | Pediatrics | 5501 Willow Creek Dr Ste 203, Springdale, AR 72762-8708 | 2018-01-15 |
| 1255517066 | Joshua R Wilkinson | Pediatrics | 5901 Riley Park Drive, Suite B, Fort Smith, AR 72916 | 2008-01-11 |
| 1285654285 | William Ladell Douglas | Pediatrics | 100 E 20th St, Suite B, Hope, AR 71801-8213 | 2006-07-20 |
| 1811955974 | Loren Barry Allen | Pediatrics | 1223 W Poplar St, Rogers, AR 72756-4245 | 2006-05-01 |
| 1972502953 | Floyd Gonzalez | Pediatrics | 821 Walter J Leeper Dr, Suite 101, De Queen, AR 71832-2591 | 2005-07-20 |
| 1700885522 | Renee Jones | Pediatrics | 615 N Main St, Brinkley, AR 72021-2507 | 2005-07-14 |
| 1588121065 | Premier Pediatrics Pllc | Pediatrics | 5901 Riley Park Drive, Suite B, Fort Smith, AR 72916 | 2019-02-21 |
| 1366767972 | Michael Israel | Pediatrics | 1 Childrens Way, Slot 512-19a, Little Rock, AR 72202-3500 | 2010-04-07 |
| 1841380342 | James Darrell Nesmith | Pediatrics | 1 Childrens Way # 653, Little Rock, AR 72202-3500 | 2006-10-13 |
| 1750484218 | Robin P Ray | Pediatrics | 403 W Oak, Suite 301, El Dorado, AR 71730 | 2006-09-07 |
| Find all providers with the same taxonomy | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
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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.