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NEW YORK INSTITUTE OF TECHNOLOGY
NPI 1760003248
Family Medicine in Jonesboro, AR

Active since May 06, 2020CLIA 04D2173420 · Waiver
333B RED WOLF BLVD, JONESBORO, AR 72405(870) 972-2054(870) 972-2131 Get Directions Write a Review

NPPES record last updated: January 8, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 8, 2021, May 6, 2020 (2 updates tracked since 2020).

About New York Institute Of Technology NPPES

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

NEW YORK INSTITUTE OF TECHNOLOGY (NPI 1760003248) is a healthcare organization registered as a family medicine in Jonesboro, Arkansas and active in the NPI registry since May 2020. The organization holds a CLIA Waiver certificate valid through October 10, 2027 and lists Sharon K Zimmerman, Assistant Dean, as its authorized official.

NPPES Registry Identity

NPI1760003248
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNEW YORK INSTITUTE OF TECHNOLOGY
Location Address333B RED WOLF BLVDJonesboro, AR 72405-9739
Mailing AddressPo Box 119State University, AR 72467-0119 · (516) 320-1466
Phone(870) 972-2054
Fax(870) 972-2131
Organization SubpartYes
Authorized OfficialSharon K ZimmermanAssistant Dean · (516) 320-1466
Enumeration DateMay 6, 2020
Last NPPES UpdateJanuary 8, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 8, 2021
✔ NPI 1760003248 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
333B RED WOLF BLVD, Jonesboro, AR 72405
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 04D2173420

New York Institute Of Technology - Arkansas · Jonesboro, AR
Active · expires Oct 10, 2027
CLIA Number04D2173420
Laboratory TypeMobile Laboratory
Certificate Effective DateOctober 11, 2025
Certificate Expiration DateOctober 10, 2027
Laboratory DirectorBrookshield Laurent
Laboratory Phone(870) 680-8829
Laboratory LocationNew York Institute Of Technology - Arkansas2405 Aggie Road, Jonesboro, AR 72401
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

RENITA ALEXANDER
Student in an Organized Health Care Education/Training Program
333B RED WOLF BLVD
JONESBORO, AR 72405
Craighead County (870) 972-2054
KATELIN PACELLA
Student in an Organized Health Care Education/Training Program
333B RED WOLF BLVD
JONESBORO, AR 72405
Craighead County (870) 972-2054
DR. DOSHA FRANCES CUMMINS
Clinical Pharmacology
333B RED WOLF BLVD
JONESBORO, AR 72405
Craighead County (870) 680-8809
WILLIAM TEDJO DO
Neuromusculoskeletal Medicine & OMM
333B RED WOLF BLVD
JONESBORO, AR 72405
Craighead County (870) 972-2054

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 New York Institute Of Technology's NPI number?

The NPI number for New York Institute Of Technology is 1760003248. It was assigned to this organization in the NPPES registry on May 6, 2020.

Where is New York Institute Of Technology located?

New York Institute Of Technology is located at 333B Red Wolf Blvd, Jonesboro, AR 72405. The listed phone number is (870) 972-2054.

What is New York Institute Of Technology's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does New York Institute Of Technology hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2173420) is associated with this NPI, valid through October 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for New York Institute Of Technology was last updated on January 8, 2021. 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.