Individual provider Active NPI

Seth B. Coulter, P.T.

  • Physical Therapist
  • Russellville, AR
National Provider Identifier
1003895343
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
624 Issued in AR
Practice address
115 Skyline Dr
Suite a
Russellville, AR 72802-3310
Phone
(479) 967-5155
Fax
(479) 967-5141
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 624 AR Primary

Addresses

Primary practice location

115 Skyline Dr
Suite a
Russellville, AR 72802-3310

Mailing address

115 Sklyline Drive Ste a
Russellville, AR 72802-3310
Phone (479) 967-5155

Other identifiers 2

IdentifierTypeStateIssuer
117393721MedicaidAR
0489820001OtherARDME MAC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119000092 AR Practitioner - Physical Therapist in Private Practice 7911817531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coulter Physical Therapy, Inc.Group PAC ID 2365352127, 3 clinicians

Practice addresses (Care Compare)

115 Skyline Dr
Russellville, AR 72802-3310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
624ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coulter Physical Therapy, Inc. Physical Therapist CurrentSince Apr 16, 1992 Accepting new patients
McElroy Physical Therapy Inc Physical Therapist PastSince May 5, 2020 Accepting new patients

Locations

101 E 3rd Ave
Crossett, AR 71635
Phone (870) 305-3173

115 Skyline Dr
#A
Russellville, AR 72802
Phone (479) 967-5115

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202428800000",
    "number": "1003895343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 SKLYLINE DRIVE STE A",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728023310",
            "telephone_number": "479-967-5155",
            "fax_number": "479-967-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SKYLINE DR",
            "address_2": "SUITE A",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728023310",
            "telephone_number": "479-967-5155",
            "fax_number": "479-967-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "SETH",
        "middle_name": "B.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2008-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117393721",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MAC",
            "identifier": "0489820001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.