| Warren Eastside School | |
|
408 N Bradley St Warren AR 71671-2208 | |
| (870) 226-6754 | |
| Not Available |
| Full Name | Warren Eastside School |
|---|---|
| Speciality | Clinic/Center |
| Location | 408 N Bradley St, Warren, Arkansas |
| Authorized Official Name and Position | Gary Allan Nichols (CEO) |
| Authorized Official Contact | 8709423000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Warren Eastside School Po Box 509 Dermott AR 71638-0509 Ph: (870) 942-3000 | Warren Eastside School 408 N Bradley St Warren AR 71671-2208 Ph: (870) 226-6754 |
| NPI Number | 1922727726 |
|---|---|
| Provider Enumeration Date | 08/24/2022 |
| Last Update Date | 07/11/2024 |
| Medicare PECOS PAC ID | 5193785590 |
|---|---|
| Medicare Enrollment ID | O20041011000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922727726 | NPI | - | NPPES |
| 302224749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Kerry F Pennington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013983873 PECOS PAC ID: 2163499450 Enrollment ID: I20040915000950 |
| Provider Name | Paul F Whipple |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447335708 PECOS PAC ID: 1850312539 Enrollment ID: I20051208000980 |
| Provider Name | Jane Pelkki |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1457577397 PECOS PAC ID: 9234211087 Enrollment ID: I20080131000678 |
| Provider Name | Andre Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124048871 PECOS PAC ID: 6709882160 Enrollment ID: I20081126000562 |
| Provider Name | Michelle C Weaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265624621 PECOS PAC ID: 8426114257 Enrollment ID: I20090304000022 |
| Provider Name | Brenda J Jacobs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720111990 PECOS PAC ID: 4486701356 Enrollment ID: I20090409000664 |
| Provider Name | Kimberly K Golden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003038167 PECOS PAC ID: 3577613439 Enrollment ID: I20090618000033 |
| Provider Name | Karen J Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285600049 PECOS PAC ID: 2264573195 Enrollment ID: I20100113000943 |
| Provider Name | Kelly Dean Shrum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427028638 PECOS PAC ID: 3577606052 Enrollment ID: I20100205000277 |
| Provider Name | Heath A Reep |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134215288 PECOS PAC ID: 1951439983 Enrollment ID: I20100512000148 |
| Provider Name | Joe H Wharton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225084577 PECOS PAC ID: 1052487329 Enrollment ID: I20100528000080 |
| Provider Name | Scott D Winston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184690455 PECOS PAC ID: 5991778516 Enrollment ID: I20101222000276 |
| Provider Name | Lisa D Kilcrease |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053439836 PECOS PAC ID: 7214126010 Enrollment ID: I20110110000577 |
| Provider Name | Meredith B Allison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619275070 PECOS PAC ID: 0941484109 Enrollment ID: I20110412001005 |
| Provider Name | Byron Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376841247 PECOS PAC ID: 9133304868 Enrollment ID: I20110425000013 |
| Provider Name | Holley D Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629337738 PECOS PAC ID: 5092970749 Enrollment ID: I20120710000083 |
| Provider Name | Vunkisha Nash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184978421 PECOS PAC ID: 5294970059 Enrollment ID: I20130327000040 |
| Provider Name | Felicia A Watkins Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003893579 PECOS PAC ID: 7214022045 Enrollment ID: I20130607000409 |
| Provider Name | Cynthia Stahley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578980595 PECOS PAC ID: 6406071760 Enrollment ID: I20140701000795 |
| Provider Name | Dana S Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659710879 PECOS PAC ID: 4486879020 Enrollment ID: I20140715001642 |
| Provider Name | Shenika Jackson King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669886552 PECOS PAC ID: 4587885223 Enrollment ID: I20141022002466 |
| Provider Name | Amanda C Lem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497006217 PECOS PAC ID: 3072744911 Enrollment ID: I20150603000942 |
| Provider Name | Melinda Balducci Upshur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518349950 PECOS PAC ID: 2264748482 Enrollment ID: I20150903000294 |
| Provider Name | Crystal Little |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821409996 PECOS PAC ID: 7517275720 Enrollment ID: I20151007001263 |
| Provider Name | Courtney S Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386026359 PECOS PAC ID: 8325356553 Enrollment ID: I20151007002200 |
| Provider Name | Joseph C Drumm |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619262680 PECOS PAC ID: 6305145020 Enrollment ID: I20160502002147 |
| Provider Name | Amy B Floyd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396074886 PECOS PAC ID: 3779877279 Enrollment ID: I20160805001552 |
| Provider Name | Toni D Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790137867 PECOS PAC ID: 0143517383 Enrollment ID: I20161003000617 |
| Provider Name | Jesse Bone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770039752 PECOS PAC ID: 6800175514 Enrollment ID: I20161122000174 |
| Provider Name | April B Glasscock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174071583 PECOS PAC ID: 7517246192 Enrollment ID: I20161123000568 |
| Provider Name | Leah Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093191025 PECOS PAC ID: 2961782768 Enrollment ID: I20161214000569 |
| Provider Name | Fredy Cordova |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548464993 PECOS PAC ID: 0345313524 Enrollment ID: I20170216000714 |
| Provider Name | Brittney Dawn Hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912445628 PECOS PAC ID: 4284910399 Enrollment ID: I20170404000092 |
| Provider Name | Katelan C Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730630849 PECOS PAC ID: 3274819172 Enrollment ID: I20170407000040 |
| Provider Name | Anthony Paul Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770020521 PECOS PAC ID: 7911271689 Enrollment ID: I20170919001609 |
| Provider Name | Myra Flemister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982128096 PECOS PAC ID: 9032483755 Enrollment ID: I20170919003630 |
| Provider Name | Dustin Strickland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235653692 PECOS PAC ID: 0547533606 Enrollment ID: I20170927002683 |
| Provider Name | Mollye J Koonce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497271456 PECOS PAC ID: 2567736622 Enrollment ID: I20170928000660 |
| Provider Name | Amy White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386157592 PECOS PAC ID: 5698036986 Enrollment ID: I20180301001226 |
| Provider Name | Laura Susan Hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063958940 PECOS PAC ID: 4587911896 Enrollment ID: I20180718001164 |
| Provider Name | Annie M Haynes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932336054 PECOS PAC ID: 7416207709 Enrollment ID: I20180907000335 |
| Provider Name | Wiiliam Hunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184102303 PECOS PAC ID: 5395095301 Enrollment ID: I20180912000494 |
| Provider Name | Amber Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962980268 PECOS PAC ID: 8921359480 Enrollment ID: I20180921001300 |
| Provider Name | Kimberly M Rawls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174001382 PECOS PAC ID: 5799037362 Enrollment ID: I20181009002465 |
| Provider Name | Kimberly Weeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205315637 PECOS PAC ID: 9234482324 Enrollment ID: I20181018001691 |
| Provider Name | Jennifer Cotton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811024276 PECOS PAC ID: 5193079291 Enrollment ID: I20181107003606 |
| Provider Name | Rebekah Ayecock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104251180 PECOS PAC ID: 9638423601 Enrollment ID: I20181205000052 |
| Provider Name | Kendal L Noble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558831644 PECOS PAC ID: 2961749924 Enrollment ID: I20190129001822 |
| Provider Name | Clark Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710448535 PECOS PAC ID: 3274866470 Enrollment ID: I20190603001456 |
| Provider Name | April Summer Mcghee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316501901 PECOS PAC ID: 3072841907 Enrollment ID: I20190829003283 |
| Provider Name | Kristen Dent |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881072791 PECOS PAC ID: 8527373604 Enrollment ID: I20190905002205 |
| Provider Name | Rebecca S Woodall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194009431 PECOS PAC ID: 1557690914 Enrollment ID: I20190910001769 |
| Provider Name | Amanda H Kelley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023587524 PECOS PAC ID: 6406188010 Enrollment ID: I20191031002434 |
| Provider Name | Kelli L Mctigrit |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093075079 PECOS PAC ID: 2860827441 Enrollment ID: I20200109001289 |
| Provider Name | Charlie Cruce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962044800 PECOS PAC ID: 7416382965 Enrollment ID: I20200110001871 |
| Provider Name | Hannah A Hilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487290961 PECOS PAC ID: 8527496314 Enrollment ID: I20200309002176 |
| Provider Name | Brittani Axie Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790340529 PECOS PAC ID: 9032547716 Enrollment ID: I20200311000932 |
| Provider Name | Jamie S Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508800707 PECOS PAC ID: 9133137003 Enrollment ID: I20200318001228 |
| Provider Name | Ashley Leanna Huitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104462712 PECOS PAC ID: 4981026804 Enrollment ID: I20200623002610 |
| Provider Name | Wendy Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306455860 PECOS PAC ID: 6608293477 Enrollment ID: I20200826000360 |
| Provider Name | Randi Leann Beard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366054959 PECOS PAC ID: 7618395864 Enrollment ID: I20200921000681 |
| Provider Name | Bridget Michele Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376134668 PECOS PAC ID: 7618382680 Enrollment ID: I20210225001009 |
| Provider Name | Scott Allison Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003394602 PECOS PAC ID: 9234546201 Enrollment ID: I20210319000016 |
| Provider Name | John Austin Beatty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578050472 PECOS PAC ID: 1153652094 Enrollment ID: I20210726000967 |
| Provider Name | Blayne E Beene |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528552130 PECOS PAC ID: 2860740495 Enrollment ID: I20210830001635 |
| Provider Name | Kacee Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730841883 PECOS PAC ID: 2769880103 Enrollment ID: I20211014003056 |
| Provider Name | Courtland Hunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821731498 PECOS PAC ID: 2062809601 Enrollment ID: I20220428001334 |
| Provider Name | Cassidy Jo Gavin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144989500 PECOS PAC ID: 3577944206 Enrollment ID: I20220713000426 |
| Provider Name | Constance Williams Chapman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760973804 PECOS PAC ID: 4688056674 Enrollment ID: I20220808002705 |
| Provider Name | Jessica Danya Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750013439 PECOS PAC ID: 4981070596 Enrollment ID: I20221208001796 |
| Provider Name | Leia Dawn O'fallon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477269306 PECOS PAC ID: 7517327240 Enrollment ID: I20230713001143 |
| Provider Name | Jaime B Harvey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215158563 PECOS PAC ID: 0749626570 Enrollment ID: I20240314002453 |
| Provider Name | Shelly Wolfe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245605054 PECOS PAC ID: 4587000203 Enrollment ID: I20240315001787 |
| Provider Name | Joshua Wood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730323064 PECOS PAC ID: 3375947575 Enrollment ID: I20240401002672 |
Wharton Clinic, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1012 E Church St, Suite C, Warren, AR 71671 Phone: 870-226-6786 Fax: 870-226-5638 | |
Harton Medical Clinic Pllc Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 614 N Martin St, Warren, AR 71671 Phone: 870-226-6580 Fax: 870-226-6554 | |
Foscue Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 W Cypress St, Warren, AR 71671 Phone: 870-226-2844 Fax: 870-226-5200 | |
Bradley County Medical Center Rural Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 304 East Central, Warren, AR 71671 Phone: 870-226-8636 Fax: 870-226-8655 | |
Mindful Health Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 W Cypress St, Warren, AR 71671 Phone: 870-226-2844 Fax: 870-226-5200 | |
Michelle Weaver, Md, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 219 E Central St, Warren, AR 71671 Phone: 501-812-7216 | |
Warren Elementary Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2018 Lady Jack Drive, Warren, AR 71671 Phone: 870-226-6754 Fax: 870-226-7925 |