JEFFERSON HOSPITAL ASSOCIATION, INC
NPI 1497102040
Family Medicine in Pine Bluff, AR
About Jefferson Hospital Association, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEFFERSON HOSPITAL ASSOCIATION, INC (NPI 1497102040), doing business as Family Health Associates Of Southeast Arkansas, is a healthcare organization registered as a family medicine in Pine Bluff, Arkansas and active in the NPI registry since May 2016. The organization maintains a secondary practice location in Pine Bluff and lists Brian Thomas, Sr. Vp And Coo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Group Practice 1
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)
Jefferson Hospital Association, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 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
106Medicare enrollment records show 106 clinicians reassign Medicare billing to Jefferson Hospital Association, Inc, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 65 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 22
Nearest to this location (20)
See all 106Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Jefferson Hospital Association, Inc's NPI number?
The NPI number for Jefferson Hospital Association, Inc is 1497102040. It was assigned to this organization in the NPPES registry on May 24, 2016. The provider is doing business as Family Health Associates of Southeast Arkansas.
Where is Jefferson Hospital Association, Inc located?
Jefferson Hospital Association, Inc is located at 1801 W 40th Ave Ste 6A, Pine Bluff, AR 71603. The listed phone number is (870) 541-9373.
What is Jefferson Hospital Association, Inc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
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 November 30, 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), 106 clinicians in 22 Medicare specialties reassign 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. The largest specialties are Nurse Practitioner (21), Family Practice (15) and Internal Medicine (11). Of these, 4 practice at this address and 65 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Jefferson Hospital Association, Inc was last updated on August 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.
# Jefferson Hospital Association, Inc · NPI 1497102040
Family Medicine organization in Pine Bluff, Arkansas. Organization record, active in the CMS NPPES registry since May 24, 2016.
## Identity
- **NPI:** 1497102040 (Entity type: Organization)
- **Enumerated:** May 24, 2016
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** Family Health Associates of Southeast Arkansas (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Brian Thomas, SR. VP AND COO
## Practice location
- **Address:** 1801 W 40TH AVE STE 6A, Pine Bluff, AR 71603-6963
- **Phone:** (870) 541-9373 · **Fax:** (870) 541-0109
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Arkansas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 106 clinicians in 22 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (21), Family Practice (15), Internal Medicine (11); 4 practice at this address and 65 within 10 miles; [full list](https://npiprofile.com/npi/1497102040/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 13, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1497102040) · Data from the CMS NPPES public registry.