NPIMap

Organization Active NPI

Mountain Home Urology, P.a.

  • Urology Physician
  • Mountain Home, AR
National Provider Identifier
1053828905
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
MOUNTAIN HOME UROLOGY, P.A.
Doing business as
Mountain Home Urology, P.A.
Practice address
15 Green Valley Dr
Mountain Home, AR 72653-8102
Phone
(870) 701-0490
NPI assigned
Jan 1, 2018
Last updated
Jun 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Authorized official

Name
Dr. Jason Teague Lindsay, MDNPI 1740356153
Title
President
Phone
(870) 701-0490

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
Urology Physician 208800000X Primary

Addresses

Primary practice location

15 Green Valley Dr
Mountain Home, AR 72653-8102

Mailing address

PO Box 910
Mountain Home, AR 72654-0910
Phone (870) 701-0490

Other names 1

  • Mountain Home Urology, P.A. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180313000321 AR Part B Supplier - Clinic/Group Practice 7315209236 Receives reassigned benefits from 2 practitioners
Practice locations: Mountain Home, AR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1514764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1053828905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726540910",
            "telephone_number": "870-701-0490",
            "fax_number": "870-701-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 GREEN VALLEY DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726538102",
            "telephone_number": "870-701-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HOME UROLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-01",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "LINDSAY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "TEAGUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-701-0490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Home Urology, P.A.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.