NPIMap

Organization Active NPI

Mercy Health Northwest Arkansas Communities

  • Orthopaedic Surgery Physician
  • Rogers, AR
National Provider Identifier
1063835908
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES
Practice address
1101 S Horsebarn Rd
Rogers, AR 72758-8237
Phone
(479) 271-9607
Fax
(479) 271-2133
NPI assigned
Jan 29, 2014
Last updated
Apr 3, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Benny J. Stover
Title
Vice President-Finance
Phone
(479) 338-2230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

1101 S Horsebarn Rd
Rogers, AR 72758-8237

Mailing address

1101 S Horsebarn Rd
Rogers, AR 72758-8237
Phone (479) 271-9607

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000788 AR Part B Supplier - Clinic/Group Practice 0648177873 Receives reassigned benefits from 485 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rogers, AR; Springdale, AR; Tontitown, AR; Bentonville, AR; Berryville, AR; Centerton, AR; Eureka Springs, AR; Green Forest, AR…

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1002 S 52nd St
Rogers, AR 72758
Phone (479) 338-3722

1101 S Horsebarn Rd
Rogers, AR 72758
Phone (479) 271-4170

2112 S 54th St
Rogers, AR 72758
Phone (479) 338-4135

2708 S Rife Medical Ln
Ste 130
Rogers, AR 72758
Phone (479) 338-5555

2708 S Rife Medical Ln
Ste T30
Rogers, AR 72758
Phone (479) 338-3999

5204 W Redbud St
Rogers, AR 72758
Phone (479) 636-0110

4600 Mercy Ln
Ste 210
Springdale, AR 72762
Phone (479) 271-9607

Practitioners & affiliated clinicians

Practitioners 81

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 81

NPI Registry JSON

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1063835908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S HORSEBARN RD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588237",
            "telephone_number": "479-271-9607",
            "fax_number": "479-271-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S HORSEBARN RD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588237",
            "telephone_number": "479-271-9607",
            "fax_number": "479-271-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-29",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "STOVER",
        "authorized_official_first_name": "BENNY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "VICE PRESIDENT-FINANCE",
        "authorized_official_telephone_number": "479-338-2230"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "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 Apr 3, 2018; 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.