Active NPI
Glomar Medical Nwa PLLC
- Family Medicine Physician
- Rogers, AR
National Provider Identifier
1063286177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- GLOMAR MEDICAL NWA PLLC
- Practice address
- 4305 S Pleasant Crossing Blvd Ste 103
Rogers, AR 72758-1347 - Phone
- (800) 511-2747
- Fax
- (501) 255-9109
- NPI assigned
- Nov 9, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jan Chesney
- Title
- Billing Manager
- Phone
- (317) 796-9785
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
4305 S Pleasant Crossing Blvd Ste 103
Rogers, AR 72758-1347
Mailing address
4305 S Pleasant Crossing Blvd Ste 103
Rogers, AR 72758-1347
Phone (800) 511-2747
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
4305 S Pleasant Crossing Blvd
Ste 103
Rogers, AR 72758
Phone (918) 625-5403
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1699355347
AR, Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699488000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1699488000000",
"number": "1063286177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4305 S PLEASANT CROSSING BLVD STE 103",
"city": "ROGERS",
"state": "AR",
"postal_code": "727581347",
"telephone_number": "800-511-2747",
"fax_number": "501-255-9109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4305 S PLEASANT CROSSING BLVD STE 103",
"city": "ROGERS",
"state": "AR",
"postal_code": "727581347",
"telephone_number": "800-511-2747",
"fax_number": "501-255-9109"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GLOMAR MEDICAL NWA PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-09",
"last_updated": "2023-11-09",
"certification_date": "2023-11-09",
"status": "A",
"authorized_official_last_name": "CHESNEY",
"authorized_official_first_name": "JAN",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "317-796-9785"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.