SCARBROUGH CLINIC INC. NPI 1386743482

NPI Information

NPI: 1386743482
Provider Name: SCARBROUGH CLINIC, INC.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 04D2023294

Address:
1901 KILLOUGH RD. NORTH
WYNNE, AR
ZIP 72396
Phone: (870) 238-8707
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SCARBROUGH CLINIC, INC. is a family nurse practitioner in Wynne, AR. SCARBROUGH CLINIC, INC. NPI is 1386743482. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1901 KILLOUGH RD. NORTH
WYNNE, AR
ZIP 72396-465
Phone: (870) 238-8707
Fax: (870) 238-8711

The provider's authorized official is Tad Scarbrough .
The authorized official title is Fnp/chiropractor/president and has the following contact phone number (870) 238-8707.

The CLIA number assigned to this NPI record is 04D2023294 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 12/13/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		1544	ARKANSAS	No
2	164W00000X	Licensed Practical Nurse		P01329	ARKANSAS	No
3	363LF0000X	Nurse Practitioner	Family	P01329	ARKANSAS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3821243	OTHER	ARKANSAS	CIGNA ID NUMBER
2	647764	OTHER	ARKANSAS	UNITED HEALTHCARE ID #
3	7359415	OTHER	ARKANSAS	AETNA ID NUMBER
4	158844718	MEDICAID	ARKANSAS
5	5U931	OTHER	ARKANSAS	AR BLUECROSSBLUESHIELD
6	19754000040	OTHER	ARKANSAS	QUALCHOICE ID NUMBER

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

NPI Synchronization or Removal

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