Active NPI
John R. Nash, MD
- Family Medicine Physician
- Berryville, AR
National Provider Identifier
1104916550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R9N04
- Practice address
- 207 Carter St
Berryville, AR 72616-4303 - Phone
- (870) 423-6661
- Fax
- (870) 423-4374
- NPI assigned
- Oct 14, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R9N04 | AR | Primary |
Addresses
Primary practice location
207 Carter St
Berryville, AR 72616-4303
Mailing address
PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51269 | Other | AR | AR BLUE SHIELD # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R9N04 | AR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1104916550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2580",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658012580",
"telephone_number": "417-829-4620",
"fax_number": "417-829-4316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 CARTER ST",
"city": "BERRYVILLE",
"state": "AR",
"postal_code": "726164303",
"telephone_number": "870-423-6661",
"fax_number": "870-423-4374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASH",
"first_name": "JOHN",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "R9N04",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AR BLUE SHIELD #",
"identifier": "51269",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Berryville, AR
- Michael S. Nelson
- Craig Milam, M.D.
- Amy Mills, LMSW
- Rachel Elizabeth Montgomery, COTA
- Jessica Keely Moschner, CNP
- Michael S Nelson, D.D.S.
- North Arkansas Regional Medical Center (Narmc Berryville Clinic)
- Orrell Enterprises Incorporated (The Medicine Chest Pharmacy)
- Orthopaedic & Sports Medicine Clinic of Northwest Arkansas, P.a.
- Orthopaedic & Sports Medicine Clinic of Northwest Arkansas, P.a.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.