CHARLIE J GOBER (NPI# 1962044800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962044800 |
| Entity Type | Individual |
| Full Name | CHARLIE J GOBER |
| Practice Address |
300 S School St Dermott AR 71638-2127 |
| Mailing Address |
Po Box 509 Dermott AR 71638-0509 |
| Practice Telephone | 8705383355 |
| Mailing Telephone | 8705385414 |
| Mailing Fax Number | 8705385412 |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2019-10-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
122323 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
300 S SCHOOL ST |
| City | DERMOTT |
| State | AR |
| Zip Code | 71638-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386758043 | Mainline Health Systems Inc | Clinic/Center | 300 S School St, Dermott, AR 71638-2228 | 2006-08-19 |
| 1710448535 | Clark N Roberts | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2019-03-26 |
| 1205315637 | Kimberly Weeks | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2018-08-07 |
| 1184102303 | William Joshua Hunter | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2018-07-31 |
| 1104361880 | Tiffany Wargo | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2017-01-04 |
| 1386026359 | Courtney Shay Johnson | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2015-06-25 |
| 1669886552 | Shenika Jackson-king | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2014-06-18 |
| 1821409996 | Crystal Little | Pediatrics | 300 S School St, Dermott, AR 71638-2127 | 2014-05-12 |
| 1659710879 | Dana Shea Phillips | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2013-06-20 |
| 1003021692 | Gary Dalton | Dentist | 300 S School St, Dermott, AR 71638-2127 | 2007-05-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104251180 | Rebekah Ayecock | Nurse Practitioner | 300 South School St, Dermott, AR 71638 | 2013-09-09 |
| 1508198201 | Roger Alan Mason | Surgery | 300 South School St., Dermott, AR 71638 | 2010-02-04 |
| 1730219353 | Dermott Day Service Center, Inc. | Day Training, Developmentally Disabled Services | 817 North School Street, Dermott, AR 71638 | 2007-03-06 |
| 1134286750 | Dermott City Nursing Home | Skilled Nursing Facility | 702 West Gaines St., Dermott, AR 71638 | 2007-01-02 |
| 1861555005 | Dermott High School | Local Education Agency (LEA) | 525 East Speedway, Dermott, AR 71638 | 2006-12-19 |
| 1811095656 | Phillip W Pennington | Dentist | 300 S School, Dermott, AR 71638 | 2006-09-20 |
| 1669401501 | Mainline Health Systems, Inc | Clinic/Center | 134 South Strickland St, Dermott, AR 71638 | 2006-07-02 |
| 1982643409 | Jeffery Fenton Dunn Sr. | Pharmacist | 111 E Peddicord Street, Dermott, AR 71638 | 2006-06-06 |
| 1609298306 | Cb King Jm | Day Training, Developmentally Disabled Services | 1109 North School, Dermott, AR 71638-0000 | 2014-01-15 |
| 1780119610 | Medical Transport Management, Inc | Ambulance | 109 W Peddicord St, Dermott, AR 71638-2115 | 2017-04-28 |
| Find all providers in zip 71638 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710448535 | Clark N Roberts | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2019-03-26 |
| 1205315637 | Kimberly Weeks | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2018-08-07 |
| 1184102303 | William Joshua Hunter | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2018-07-31 |
| 1386026359 | Courtney Shay Johnson | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2015-06-25 |
| 1669886552 | Shenika Jackson-king | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2014-06-18 |
| 1659710879 | Dana Shea Phillips | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2013-06-20 |
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|---|---|---|---|---|
| 1023617594 | Mckenzie Lauren Cotton | Nurse Practitioner | 1065 Skyline Dr, Conway, AR 72032-3530 | 2020-10-25 |
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| 1063010874 | Phillip Wayne Stokes Jr. | Nurse Practitioner | 31 Ashcraft Ct, Paragould, AR 72450-7592 | 2020-10-14 |
| 1720685308 | Dannie Evenda Loy | Nurse Practitioner | 101 Hammond Drive #2131, Hot Springs, AR 71914 | 2020-10-06 |
| 1457958233 | Kaitlyn Soffray Simmons | Nurse Practitioner | 500 Kitchen St, Jonesboro, AR 72401-3135 | 2020-10-05 |
| 1013524487 | Danielle Lynn Frueh | Nurse Practitioner | 103 W University St, Siloam Springs, AR 72761-2663 | 2020-09-29 |
| 1407463938 | Aleshia Williams | Nurse Practitioner | 5401 Clear Creek Ln, Jonesboro, AR 72404-7006 | 2020-09-29 |
| 1801403217 | Jessica Evelyn Mcnamee | Nurse Practitioner | 180 Medical Park Pl Ste 202, Hot Springs, AR 71901-8067 | 2020-09-29 |
| 1437765831 | Allison Nicole Hitt | Nurse Practitioner | 3644 W Hwy 18, Manila, AR 72442 | 2020-09-21 |
| 1528674181 | Maggie Mullican | Nurse Practitioner | 7084 S Pleasant Ridge Dr, Fayetteville, AR 72704-5447 | 2020-09-18 |
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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.