Benton Neurocare Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BENTON NEUROCARE INC.

Practice address

811 SE 28TH St Ste 5
Bentonville, AR 72712-4294

Phone

(479) 254-9761

Fax

(479) 254-9732

NPI assigned

Feb 13, 2008

Organization subpart

No

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

Authorized official

Name

Ahmad Al-Khatib, M.D.NPI 1548273394

Title

President

Phone

(479) 254-9761

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ahmad Al-Khatib, MD

  • Neurology Physician
  • Bentonville, AR
  • NPI 1548273394

  AR

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1063680973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 SE 28TH ST STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124294",
            "telephone_number": "479-254-9761",
            "fax_number": "479-254-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 SE 28TH ST STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124294",
            "telephone_number": "479-254-9761",
            "fax_number": "479-254-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENTON NEUROCARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "AL-KHATIB",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-254-9761",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Bemis, LMT
• Bentley Elizabeth Bennett
• Brea Ann Bennett, SLP, M.S. CCC-SLP
• David Benson, M.D.
• Benton Emergency Group LLC
• Benton Nursing, LLC
• Bentonville Ambulatory Surgery Center, LLC
• Bentonville Anesthesia PLLC
• Bentonville Assisted Living Services
• Bentonville Endoscopy Center, LLC

• All providers in Bentonville, AR
• Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.