NPIMap

Organization Active NPI

Prime Physicians LLC

  • General Practice Physician
  • Fort Smith, AR
National Provider Identifier
1033454723
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PRIME PHYSICIANS LLC
Practice address
8300 Chad Colley Blvd
Fort Smith, AR 72916-6175
Phone
(479) 242-4455
Fax
(479) 974-4570
NPI assigned
Dec 6, 2012
Last updated
Jul 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Authorized official

Name
Kalyan Akkineni, MDNPI 1679780969
Title
Partner
Phone
(423) 426-3918

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

8300 Chad Colley Blvd
Fort Smith, AR 72916-6175

Mailing address

5808 Callaway LN
Fort Smith, AR 72916-8437
Phone (479) 242-4455

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130128000344 AR Part B Supplier - Clinic/Group Practice 4183878176 Receives reassigned benefits from 46 practitioners
Practice locations: Clarksville, AR; Fort Smith, AR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1033454723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5808 CALLAWAY LN",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729168437",
            "telephone_number": "479-242-4455",
            "fax_number": "479-974-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CHAD COLLEY BLVD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729166175",
            "telephone_number": "479-242-4455",
            "fax_number": "479-974-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "AKKINENI",
        "authorized_official_first_name": "KALYAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "423-426-3918",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.