Jerry Ed Fenter, MPT

Key facts

NPI

1003989765

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

920842873 (AR)

Practice address

2860 I 55 Service Rd
Ste C
Marion, AR 72364

Phone

(870) 739-8686

Fax

(870) 739-8656

NPI assigned

Nov 17, 2006

Sex

Male

Sole proprietor

Yes

Organizations & group practices 3

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.

• Fenter Physical Therapy LLC Physical Therapist · Marion, AR · NPI 1992907067
  Medicare reassignment Care Compare group NPD Authorized official AR · PHYSICAL THERAPIST · TN
• Fenter Physical Therapy Durable Medical Equipment & Medical Supplies · West Memphis, AR · NPI 1518384536
  NPD (past) Authorized official
• F&S Physical Therapy, Inc. Physical Therapist · Alma, AR · NPI 1518936418
  NPD (past) PHYSICAL THERAPIST

Medicare Care Compare profile

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fenter Physical Therapy LLC (9 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in AR, TN

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 12, 2011.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1003989765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 I 55 SERVICE RD",
            "address_2": "STE C",
            "city": "MARION",
            "state": "AR",
            "postal_code": "72364",
            "telephone_number": "870-739-8686",
            "fax_number": "870-739-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 I 55 SERVICE RD",
            "address_2": "STE C",
            "city": "MARION",
            "state": "AR",
            "postal_code": "72364",
            "telephone_number": "870-739-8686",
            "fax_number": "870-739-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTER",
        "first_name": "JERRY",
        "middle_name": "ED",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "920842873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159618721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, AR

• Kandis Farmer
• Krista Fauber, MHPP
• Faulkner Eye Clinic
• Martin L Faulkner, O.D.
• Fenter Physical Therapy LLC
• Zack Fenter, PTA
• Veronica Ferebee
• Kyla Floresca
• Eleanor Fondren, LMSW
• Tangella Foreman, LCSW

All providers in Marion, AR · Physical Therapist in Arkansas