SOUTHEAST ARKANSAS PRIMARY CARE ASSOCIATES (NPI# 1619321221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619321221 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST ARKANSAS PRIMARY CARE ASSOCIATES |
| Practice Address |
3801 W 28th Ave Pine Bluff AR 71603-4774 |
| Practice Telephone | 8702091601 |
| Mailing Telephone | 8702091601 |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-04-20 |
| Authorized Official Name | SHAUN A YOUNG (PRESIDENT / CEO) |
| Authorized Official Telephone | 8702091601 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
A004617 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3801 W 28TH AVE |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-4774 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285091140 | Shaun Young | Nurse Practitioner | 3801 W 28th Ave, Pine Bluff, AR 71603-4774 | 2016-01-24 |
| 1720445687 | Dorothy Young | Nurse Practitioner | 3801 W 28th Ave, Pine Bluff, AR 71603-4774 | 2016-01-24 |
| 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 | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073631 | Christy Nicole Reed | Nurse Practitioner | 1200 University Dr, Pine Bluff, AR 71601-2780 | 2020-11-05 |
| 1427666569 | Angela Turner | Nurse Practitioner | 1401 S State St Ste C, Pine Bluff, AR 71601-5827 | 2020-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611361 | Jamie L Cagle | Nurse Practitioner | 1500 Dodson Ave # 60, Fort Smith, AR 72901-5182 | 2020-02-21 |
| 1306489281 | Lawana Bradley | Nurse Practitioner | 296 Lake Rd, Atkins, AR 72823-7165 | 2019-10-23 |
| 1679116024 | Michelle Grant | Nurse Practitioner | 130 Mark Cir, Monticello, AR 71655-5617 | 2019-10-17 |
| 1780238782 | Chelsea D. Marquis | Nurse Practitioner | 4401 Sw Flagstone Blvd, Bentonville, AR 72713-4005 | 2019-07-29 |
| 1265094478 | Kristyn Clark | Nurse Practitioner | 210 S Thompson St, Springdale, AR 72764-4239 | 2019-07-08 |
| 1184194029 | Stephanie Lucille Converse | Nurse Practitioner | 326 Lee Rd # 601, Brickeys, AR 72320-8000 | 2018-12-04 |
| 1174026165 | Phoebe Grace Chandler | Nurse Practitioner | 3782 Solitude St, Springdale, AR 72764-6368 | 2018-03-15 |
| 1386143717 | Andrew Freeman Oliver | Nurse Practitioner | 650 United Dr Ste 200, Conway, AR 72032-7001 | 2018-02-12 |
| 1760908982 | Jamie Leigh Ferguson | Nurse Practitioner | 4301 W Markham St # 721-3, Little Rock, AR 72205-7101 | 2017-08-18 |
| 1336677731 | Robert Lee Mcgruder Jr. | Nurse Practitioner | 2308 Royal Ct Unit B, Bryant, AR 72022-4216 | 2017-05-30 |
| Find all providers with the same taxonomy | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
Please comment or provide details below to improve the information on SOUTHEAST ARKANSAS PRIMARY CARE ASSOCIATES.
| 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.