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NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
NPI 1417721689
Clinic/Center - Radiology, Mobile Mammography in Jonesboro, AR

Active since November 08, 2023
4800 E JOHNSON AVE, JONESBORO, AR 72405(870) 936-8000 Get Directions Write a Review

NPPES record last updated: November 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Northeast Arkansas Clinic Charitable Foundation, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC. (NPI 1417721689) is a healthcare organization registered as a radiology, mobile mammography in Jonesboro, Arkansas and active in the NPI registry since November 2023. The organization lists Gregory M Duckett, Sr Vp/chief Legal Officer, as its authorized official.

NPPES Registry Identity

NPI1417721689
Entity TypeOrganization
Primary Taxonomy261QR0207X
Legal Business NameNORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
Location Address4800 E JOHNSON AVEJonesboro, AR 72405-8413
Mailing Address350 N Humphreys BlvdMemphis, TN 38120-2177 · (901) 227-5233
Phone(870) 936-8000
Organization SubpartNo
Authorized OfficialGregory M DuckettSr Vp/chief Legal Officer · (901) 227-5233
Enumeration DateNovember 8, 2023
NPPES CertifiedOctober 24, 2023
✔ NPI 1417721689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Radiology, Mobile MammographyAmbulatory Health Care Facilities
Taxonomy Code261QR0207X
Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
4800 E JOHNSON AVE, Jonesboro, AR 72405
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. REFAYAT AHSEN MD
Internal Medicine
4800 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (865) 684-0799
JARRYD A DEMPSEY PT
Physical Therapist
4800 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 936-8000
DR. FAHAD KHAN DO
Student in an Organized Health Care Education/Training Program
4800 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 936-1000
WILLIAM B ROTH DO
Hospitalist
4800 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 936-1000
SAMUEL DAVID MARTIN DO
Student in an Organized Health Care Education/Training Program
4800 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 936-1000
RANYA HAIDAR AL-KHAFAJI MD
Student in an Organized Health Care Education/Training Program
4800 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 936-1000
KATIE JUSTINE CRISMAN CRNA
Nurse Anesthetist, Certified Registered
4800 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 936-1000
MR. PHILLIP WAYNE STOKES JR. FNP-C
Nurse Practitioner (Family)
4800 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 936-8000

Frequently 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 Northeast Arkansas Clinic Charitable Foundation, Inc.'s NPI number?

The NPI number for Northeast Arkansas Clinic Charitable Foundation, Inc. is 1417721689. It was assigned to this organization in the NPPES registry on November 8, 2023.

Where is Northeast Arkansas Clinic Charitable Foundation, Inc. located?

Northeast Arkansas Clinic Charitable Foundation, Inc. is located at 4800 E Johnson Ave, Jonesboro, AR 72405. The listed phone number is (870) 936-8000.

What is Northeast Arkansas Clinic Charitable Foundation, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, Mobile Mammography, with taxonomy code 261QR0207X.

When was this NPI record last updated?

The NPPES record for Northeast Arkansas Clinic Charitable Foundation, Inc. was last updated on November 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.