| Jefferson Regional Medical Center | |
|
1600 W. 40th Avenue Pine Bluff AR 71603-6301 | |
| (870) 541-7100 | |
| (870) 541-7964 |
| Full Name | Jefferson Regional Medical Center |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 1600 W. 40th Avenue, Pine Bluff, Arkansas |
| Authorized Official Name and Position | Kristen Jade Davis (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Contact | 8705417173 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Regional Medical Center 1600 W. 40th Avenue Pine Bluff AR 71603-6301 Ph: (870) 541-7100 | Jefferson Regional Medical Center 1600 W. 40th Avenue Pine Bluff AR 71603-6301 Ph: (870) 541-7100 |
| NPI Number | 1710931985 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 10/21/2020 |
| Certification Date | 10/06/2020 |
| Medicare PECOS PAC ID | 8123927431 |
|---|---|
| Medicare Enrollment ID | O20040429000375 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710931985 | NPI | - | NPPES |
| 040071 | Other | AR | MEDICARE PART A |
| 103078002 | Medicaid | AR | |
| 5000023 | Other | AR | UNITED HEALTHCARE |
| 045307 | Other | AR | MEDICARE PART A |
| 04S071 | Other | AR | MEDICARE PART A |
| 10071 | Other | AR | BLUE CROSS PROVIDER # |
| 102916105 | Medicaid | AR | |
| 15307 | Other | AR | BLUE CROSS SNF PROVIDER # |
| Provider Name | Ayman A Alshami |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295799443 PECOS PAC ID: 4385548361 Enrollment ID: I20031121000234 |
| Provider Name | Olabode Olumofin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720025513 PECOS PAC ID: 9638069727 Enrollment ID: I20040319001493 |
| Provider Name | Charles Edward Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972617280 PECOS PAC ID: 1658362645 Enrollment ID: I20040519000852 |
| Provider Name | Janet Curry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730300476 PECOS PAC ID: 0345220497 Enrollment ID: I20040721000413 |
| Provider Name | Sadeem Mahmood |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245299924 PECOS PAC ID: 1052378148 Enrollment ID: I20041209001033 |
| Provider Name | Shabbir A Dharamsey |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972523801 PECOS PAC ID: 0547159295 Enrollment ID: I20050114000534 |
| Provider Name | Lori A Maddox |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699979856 PECOS PAC ID: 6002857620 Enrollment ID: I20050513000298 |
| Provider Name | Nauman Yunus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487601712 PECOS PAC ID: 7911921994 Enrollment ID: I20060117000998 |
| Provider Name | Timothy P Mcclure |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437262573 PECOS PAC ID: 4486652468 Enrollment ID: I20061130000073 |
| Provider Name | Nicholas P Willis |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1629292883 PECOS PAC ID: 2668545294 Enrollment ID: I20080930000671 |
| Provider Name | Larisa Kachowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023214574 PECOS PAC ID: 5294885521 Enrollment ID: I20090609000162 |
| Provider Name | Mervin D Terrell |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1043202856 PECOS PAC ID: 3274678941 Enrollment ID: I20100305000128 |
| Provider Name | James S Cash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003826199 PECOS PAC ID: 6204971856 Enrollment ID: I20100306000304 |
| Provider Name | John T Skowronski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598866105 PECOS PAC ID: 9638134547 Enrollment ID: I20100322000530 |
| Provider Name | Currin Nichol |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013919299 PECOS PAC ID: 8921905605 Enrollment ID: I20100623001012 |
| Provider Name | Michele A Pashkevich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659319879 PECOS PAC ID: 1951584655 Enrollment ID: I20110317000455 |
| Provider Name | Linda G Cabine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932164084 PECOS PAC ID: 6204008865 Enrollment ID: I20111004000721 |
| Provider Name | Muazzum Aman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306157037 PECOS PAC ID: 3274790639 Enrollment ID: I20120214000065 |
| Provider Name | Marjorie Antenor Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902038375 PECOS PAC ID: 8729247374 Enrollment ID: I20120316000696 |
Ideas Emerge Counseling And Consulting, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2901 S Hemlock St, Pine Bluff, AR 71603 Phone: 870-489-7002 | |
Mind Over Matter Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3041 W 28th Ave, Pine Bluff, AR 71603 Phone: 870-619-9018 | |
Addiction Recovery Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 W 3rd Ave # 12, 200, Pine Bluff, AR 71601 Phone: 870-730-1150 Fax: 870-543-4952 | |
Rogers Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 813 W 6th Ave, Pine Bluff, AR 71601 Phone: 870-568-4502 Fax: 870-395-7086 | |
The P.a.t. Center: People Advocating Transition Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 620 South Laurel Street, Pine Bluff, AR 71601 Phone: 870-534-4900 Fax: 870-534-4906 | |
Reform, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 807 W 6th Ave, Pine Bluff, AR 71601 Phone: 870-510-5031 Fax: 501-421-3418 | |
The Pat Center Ii, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 620 S Laurel St Rm 16, Pine Bluff, AR 71601 Phone: 870-534-2039 Fax: 870-534-2608 |