Phillip Runyan

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

3399 Finch Rd
Bismarck, AR 71929-7541

Phone

(501) 865-3363

NPI assigned

Apr 11, 2008

Last updated

Nov 18, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• TFS of Gurdon Inc

  dba Therapeutic Family Services

  • Community/Behavioral Health Agency
  • Malvern, AR
  • NPI 1639180805
  Medicare reassignment NPD

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1063685840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "BISMARCK",
            "state": "AR",
            "postal_code": "719290108",
            "telephone_number": "501-865-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3399 FINCH RD",
            "city": "BISMARCK",
            "state": "AR",
            "postal_code": "719297541",
            "telephone_number": "501-865-3363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Wellness Way",
            "address_purpose": "LOCATION",
            "city": "Hot Springs",
            "state": "AR",
            "postal_code": "719136478",
            "country_code": "US",
            "telephone_number": "501-624-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUNYAN",
        "first_name": "PHILLIP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea McDaniel, MHPP
• Mindy D. Menotti
• Heather Roberts, MS, LAC
• Ruby Wade LCSW LLC
• Connie Runyan
• Saundra Leanne Schultz, LPC
• Nancy Shaw, COTA
• Shine Therapy Inc.
• Nicole Leanne Smart, CIT
• Jana Smith, MHPP

• Professional Counselor in Bismarck, AR
• Providers in Bismarck, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.