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HOT SPRINGS PEDIATRIC CLINICP.A. NPI 1134141682


NPI Information

NPI: 1134141682
Provider Name: HOT SPRINGS PEDIATRIC CLINIC,P.A.

Doing Business As: HOT SPRINGS PEDIATRIC CLINIC, P.A.

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 04D0699364

Address:
1920 MALVERN AVE
HOT SPRINGS, AR
ZIP 71901
Phone: (501) 321-1314
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HOT SPRINGS PEDIATRIC CLINIC,P.A. is a pediatrics in Hot Springs, AR. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. HOT SPRINGS PEDIATRIC CLINIC,P.A. NPI is 1134141682. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Hot Springs Pediatric Clinic, P.a..

The provider's business location address is:

1920 MALVERN AVE
HOT SPRINGS, AR
ZIP 71901-752
Phone: (501) 321-1314
Fax: (501) 321-1810

The provider's authorized official is Jana Marie Martin .
The authorized official title is Owner and has the following contact phone number (501) 321-1314.

The CLIA number assigned to this NPI record is 04D0699364 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/24/2006 and was last updated on 10/11/2011.


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
1363LP0200XNurse PractitionerPediatricsA02978ARKANSASNo
2208000000XPediatricsE-2525ARKANSASNo
3208000000XPediatricsE-3838ARKANSASNo
4208000000XPediatricsE-4451ARKANSASNo
5208000000XPediatricsE-7142ARKANSASNo
6363LP0200XNurse PractitionerPediatricsA02978ANPARKANSASNo
7208000000XPediatricsR-4078ARKANSASYes

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
11134141682MEDICAIDARKANSAS

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: 4/28/2024

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