JEFFERSON HOSPITAL ASSOCIATION, INC.
NPI 1922578327
Family Medicine in Pine Bluff, AR

Active since November 28, 2018
1801 W 40TH AVE STE 6A, PINE BLUFF, AR 71603(870) 541-9373(870) 541-0109 Get Directions Write a Review

NPPES record last updated: November 28, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jefferson Hospital Association, Inc. NPPES

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

JEFFERSON HOSPITAL ASSOCIATION, INC. (NPI 1922578327), doing business as Family Health Assoc Of Southeast Ar, is a healthcare organization registered as a family medicine in Pine Bluff, Arkansas and active in the NPI registry since November 2018. The organization lists Bryan Jackson, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1922578327
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameJEFFERSON HOSPITAL ASSOCIATION, INC.
Location Address1801 W 40TH AVE STE 6APine Bluff, AR 71603-6963
Mailing AddressPo Box 2650Pine Bluff, AR 71613-2650 · (870) 541-7235
Fax(870) 541-0109
Organization SubpartNo
Authorized OfficialBryan JacksonChief Financial Officer · (870) 541-7141
Enumeration DateNovember 28, 2018
✔ NPI 1922578327 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.
1801 W 40TH AVE STE 6A, Pine Bluff, AR 71603

Other Names 1

Doing Business AsFamily Health Assoc Of Southeast Ar

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

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.

StateEnrollment IDDue date
StateArkansasEnrollment IDO20040106000512Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

106

Medicare enrollment records show 106 clinicians reassign Medicare billing to Jefferson Hospital Association, Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 66 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 22

Nurse Practitioner21
Family Practice15
Internal Medicine11
Neurology9
General Surgery7
Critical Care (Intensivists)5
Obstetrics/Gynecology5
Nephrology4
14 other specialties29

Nearest to this location (20)

See all 106
Otolaryngology
NPI 1831338730
1801 W 40TH AVE STE 1B
Pine Bluff, AR 71603
(870) 541-6055
✔ PECOS✔ Accepts MedicareSame address
Gastroenterology
NPI 1770775157
1801 W 40TH AVE STE 7B
Pine Bluff, AR 71603
(870) 541-7201
✔ PECOS✔ Accepts Medicare0.1 mi
Qualified Audiologist
NPI 1942144498
1801 W 40TH AVE STE 1A
Pine Bluff, AR 71603
(870) 541-6055
✔ Accepts Medicare0.1 mi
Family Practice
NPI 1245234061
1801 W 40TH AVE STE 6A
Pine Bluff, AR 71603
(870) 541-9373
✔ PECOS✔ Accepts Medicare0.1 mi
General Surgery
NPI 1447216270
1609 W 40TH AVE STE 403
Pine Bluff, AR 71603
(870) 534-4188
✔ PECOS✔ Accepts Medicare0.1 mi
Cardiovascular Disease (Cardiology)
NPI 1730491960
1609 W 40TH AVE STE 403
Pine Bluff, AR 71603
(870) 541-4285
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1356005250
1609 W 40TH AVE STE 205
Pine Bluff, AR 71603
(870) 541-7211
✔ PECOS0.1 mi
Obstetrics/Gynecology
NPI 1407852734
1609 W 40TH AVE STE 300
Pine Bluff, AR 71603
(870) 541-6045
✔ PECOS✔ Accepts Medicare0.1 mi
Orthopedic Surgery
NPI 1770750176
1609 W 40TH AVE SUITE 501
Pine Bluff, AR 71603
(870) 534-3449
✔ PECOS✔ Accepts Medicare0.1 mi
Hematology/Oncology
NPI 1548668916
1609 W 40TH AVE STE 205
Pine Bluff, AR 71603
(870) 541-3230
✔ PECOS✔ Accepts Medicare0.1 mi
Internal Medicine
NPI 1871955526
1609 W 40TH AVE STE 202A
Pine Bluff, AR 71603
(870) 541-7211
✔ PECOS✔ Accepts Medicare0.1 mi
Radiation Oncology
NPI 1710997655
1609 W 40TH AVE STE 111
Pine Bluff, AR 71603
(870) 541-7211
✔ PECOS✔ Accepts Medicare0.1 mi
Critical Care (Intensivists)
NPI 1881853133
1609 W 40TH AVE STE 403
Pine Bluff, AR 71603
(870) 541-6070
✔ PECOS✔ Accepts Medicare0.1 mi
Interventional Cardiology
NPI 1558898064
1609 W 40TH AVE STE 403
Pine Bluff, AR 71603
(870) 541-4285
✔ PECOS✔ Accepts Medicare0.1 mi
Nephrology
NPI 1598771677
1601 W 40TH AVE
Pine Bluff, AR 71603
(870) 541-6000
✔ PECOS✔ Accepts Medicare0.1 mi
Pulmonary Disease
NPI 1629078266
1601 W 40TH AVE SUITE 301
Pine Bluff, AR 71603
(870) 541-4280
0.1 mi
Urology
NPI 1457858508
1601 W 40TH AVE STE 301C
Pine Bluff, AR 71603
(870) 541-6060
✔ PECOS✔ Accepts Medicare0.1 mi
Hospitalist
NPI 1407089436
1600 W 40TH AVE
Pine Bluff, AR 71603
(870) 541-8767
✔ PECOS✔ Accepts Medicare0.1 mi
Rheumatology
NPI 1083268478
1420 W 43RD AVE STE A
Pine Bluff, AR 71603
(870) 541-6015
✔ PECOS✔ Accepts Medicare0.3 mi
General Practice
NPI 1427085075
4310 S MULBERRY ST
Pine Bluff, AR 71603
(870) 541-8747
✔ PECOS0.3 mi
See all 106 clinicians

Source: 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 1922578327. It was assigned to this organization in the NPPES registry on November 28, 2018. The provider is doing business as Family Health Assoc of Southeast AR.

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, 1 practice at this address and 66 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 November 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.