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GREAT RIVER PEDIATRIC CLINIC
NPI 1467586131
Pediatrics in Blytheville, AR

Active since March 15, 2007CLIA 04D1064229 · Waiver
1521 N 10TH ST, STE F, BLYTHEVILLE, AR 72315(870) 780-6832(870) 780-6919 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Great River Pediatric Clinic NPPES

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

GREAT RIVER PEDIATRIC CLINIC (NPI 1467586131) is a healthcare organization registered as a pediatrics in Blytheville, Arkansas and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through January 31, 2027 and lists Benjamin Asafo-boakye, Pediatrician, as its authorized official.

NPPES Registry Identity

NPI1467586131
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameGREAT RIVER PEDIATRIC CLINIC
Location Address1521 N 10TH ST, STE FBlytheville, AR 72315-1405
Mailing Address1521 N 10th St, Ste FBlytheville, AR 72315-1405 · (870) 780-6832 · Fax (870) 780-6919
Phone(870) 780-6832
Fax(870) 780-6919
Organization SubpartNo
Authorized OfficialBenjamin Asafo-boakyePediatrician · (870) 780-6832
Enumeration DateMarch 15, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1467586131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in AR · E-4133
Definition
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.
1521 N 10TH ST, Blytheville, AR 72315
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Other Identifiers 1

Other5F511AR · Blue Cross Blue Shield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

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 04D1064229

Great River Pediatric Clinic · Blytheville, AR
Active · expires Jan 31, 2027
CLIA Number04D1064229
Laboratory TypePhysician Office
Certificate Effective DateFebruary 1, 2025
Certificate Expiration DateJanuary 31, 2027
Laboratory DirectorBenjamin Asafo Boakye MD
Laboratory Phone(870) 780-6832
Laboratory LocationGreat River Pediatric Clinic1521 North 10th Street Suite F, Blytheville, AR 72315
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

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

WE CARE & WE DELIVER, INC.
Internal Medicine (Critical Care Medicine)
1521 N 10TH ST, SUITE D
BLYTHEVILLE, AR 72315
Mississippi County (870) 377-3742
DR. KAREN SUE HESTER MD
Pediatrics
1521 N 10TH ST, SUITE C
BLYTHEVILLE, AR 72315
Mississippi County (870) 762-5360
ANES W. ABRAHAM M.D. P.A.
Specialist
1521 N 10TH ST, SUITE H
BLYTHEVILLE, AR 72315
Mississippi County (870) 763-1700
JOHN WHITE
Specialist
1521 N 10TH ST
BLYTHEVILLE, AR 72315
Mississippi County (870) 763-4224
DR. RICHARD LEE HESTER MD
Internal Medicine
1521 N 10TH ST, STE C
BLYTHEVILLE, AR 72315
Mississippi County (870) 762-5360
DR. JAMES DAVIS RUSSELL MD
General Practice
1521 N 10TH ST, STE C
BLYTHEVILLE, AR 72315
Mississippi County (870) 762-5360
FAMILY MEDICINE ASSOCIATES OF BLYTHEVILLE PA
Family Medicine
1521 N 10TH ST, STE C
BLYTHEVILLE, AR 72315
Mississippi County (870) 762-5360
CONNIE KAY ASH APRN
Nurse Practitioner (Family)
1521 N 10TH ST, SUITE C
BLYTHEVILLE, AR 72315
Mississippi County (870) 762-5360

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 Great River Pediatric Clinic's NPI number?

The NPI number for Great River Pediatric Clinic is 1467586131. It was assigned to this organization in the NPPES registry on March 15, 2007.

Where is Great River Pediatric Clinic located?

Great River Pediatric Clinic is located at 1521 N 10th St Ste F, Blytheville, AR 72315. The listed phone number is (870) 780-6832.

What is Great River Pediatric Clinic's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Great River Pediatric Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D1064229) is associated with this NPI, valid through January 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Great River Pediatric Clinic accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Great River Pediatric Clinic 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 Great River Pediatric Clinic was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.