ENDOCRINOLOGY OF SOUTH ARKANSAS
NPI 1306097365
Clinic/Center in White Hall, AR
About Endocrinology Of South Arkansas NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ENDOCRINOLOGY OF SOUTH ARKANSAS (NPI 1306097365) is a healthcare organization registered as a clinic/center in White Hall, Arkansas and active in the NPI registry since October 2008. The organization holds a CLIA Waiver certificate valid through March 27, 2028 and lists Walter Johnson, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Endocrinology Of South Arkansas is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Endocrinology Of South Arkansas, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 04D0997860
Endocrinology Of South Arkansas · White Hall, ARFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jefferson Hospital Association, Inc.'s NPI number?
The NPI number for Jefferson Hospital Association, Inc. is 1306097365. It was assigned to this organization in the NPPES registry on October 8, 2008. The provider is doing business as Endocrinology Of South Arkansas.
Where is Jefferson Hospital Association, Inc. located?
Jefferson Hospital Association, Inc. is located at 7500 Dollarway Rd Suite 404, White Hall, AR 71602. The listed phone number is (870) 879-9595.
What is Jefferson Hospital Association, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Jefferson Hospital Association, Inc. enrolled in Medicare?
Yes. Jefferson Hospital Association, Inc. is registered in the Medicare PECOS enrollment system.
When is Jefferson Hospital Association, Inc.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arkansas, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Jefferson Hospital Association, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Endocrinology) reassigns their Medicare billing to Jefferson Hospital Association, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Jefferson Hospital Association, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D0997860) is associated with this NPI, valid through March 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Jefferson Hospital Association, Inc. accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Jefferson Hospital Association, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jefferson Hospital Association, Inc. was last updated on January 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Endocrinology Of South Arkansas · NPI 1306097365
Clinic/Center organization in White Hall, Arkansas. Organization record, active in the CMS NPPES registry since October 8, 2008.
## Identity
- **NPI:** 1306097365 (Entity type: Organization)
- **Enumerated:** October 8, 2008
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Legal business name:** Jefferson Hospital Association, Inc.
- **Organization subpart:** No
- **Authorized official:** Walter Johnson, CEO
## Practice location
- **Address:** 7500 DOLLARWAY RD, SUITE 404, White Hall, AR 71602-3027
- **Phone:** (870) 879-9595 · **Fax:** (870) 879-9599
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Arkansas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Endocrinology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 21, 2011
- **Other identifiers:** Medicare PIN 5G136 (AR); Other 5G130 (AR); Medicaid 176263002 (AR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1306097365) · Data from the CMS NPPES public registry.