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CENTER FOR PEDIATRIC NEUROSCIENCE PLLC NPI 1174826499


NPI Information

NPI: 1174826499
Provider Name: CENTER FOR PEDIATRIC NEUROSCIENCE, PLLC
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization
Address:
2808 FOX MEADOW LN
JONESBORO, AR
ZIP 72404
Phone: (870) 932-4245
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CENTER FOR PEDIATRIC NEUROSCIENCE, PLLC is a clinical neuropsychologist in Jonesboro, AR. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. CENTER FOR PEDIATRIC NEUROSCIENCE, PLLC NPI is 1174826499. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2808 FOX MEADOW LN
JONESBORO, AR
ZIP 72404-346
Phone: (870) 932-4245

The provider's authorized official is Job D Caspall .
The authorized official title is Business Manager and has the following contact phone number (901) 603-9936.

The enumeration date for this NPI number is 12/8/2010 and was last updated on 7/10/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103G00000XClinical Neuropsychologist11-16PARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14302608OTHERTENNESSEEBLUE CROSS BLUE SHIELD
200118484MEDICAIDMISSISSIPPI
3189059744MEDICAIDARKANSAS
43583920MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.