Individual provider Active NPI

Carter Dalton, M.D.

  • Emergency Medicine Physician
  • Benton, AR
National Provider Identifier
1013943034
Registry record updated Mar 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E1701 Issued in AR
Practice address
2909 Military Rd
Benton, AR 72015-2721
Phone
(501) 315-6500
Fax
(501) 315-0006
NPI assigned
Jun 23, 2006
Last updated
Mar 2, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E1701 AR Primary

Addresses

Primary practice location

2909 Military Rd
Benton, AR 72015-2721

Mailing address

2909 Military Rd
Benton, AR 72015-2721
Phone (501) 315-6500

Other identifiers 2

IdentifierTypeStateIssuer
135254001MedicaidAR
5K862OtherARBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071023000404 AR Practitioner - Emergency Medicine 3971699893 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E1701ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Jan 1, 2017 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Jan 1, 2017 Accepting new patients

Locations

1 Medical Park Dr
Bryant, AR 72015
Phone (501) 776-6000

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

7 Shackleford West Blvd
Little Rock, AR 72211
Phone (501) 614-3671

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235952000000",
    "number": "1013943034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 MILITARY RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152721",
            "telephone_number": "501-315-6500",
            "fax_number": "501-315-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 MILITARY RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152721",
            "telephone_number": "501-315-6500",
            "fax_number": "501-315-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "CARTER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2009-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E1701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135254001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5K862",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.