Prospective Health LTD
Organization Active NPI Family Medicine Physician · Benton, AR
NPI 1114058682 · NPPES record last updated Sep 3, 2024
Key facts
- NPI
- 1114058682
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- PROSPECTIVE HEALTH LTD
- Practice address
- 1304 Military Rd
Benton, AR 72015 - Phone
- (501) 778-0934
- Fax
- (501) 778-8377
- NPI assigned
- Mar 8, 2007
- Organization subpart
- No
Authorized official
- Name
- Courtney E Salmon
- Title
- Administrator
- Phone
- (501) 303-7779
Practitioners 11
-
Mark E Albey, M.D.
-
Evelyn L Cathcart, M.D.
-
Callie Curtis, APRN
-
Jared A Dixon, MD
-
Melanie Mabry, APRN
-
Joseph William Morgan, D.O.
-
Kristen N Pollich, M.D.
-
Molly Bowers, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0466158 | Family Practice Associates | Provider-performed microscopy | Sep 15, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070920000730 | AR | Part B Supplier - Clinic/Group Practice | 1456445402 |
Receives reassigned benefits from 9 practitioners Practice locations: Benton, AR |
National Provider Directory
Locations
1304 Military Rd
Benton, AR 72015
Phone (501) 778-0934
Interoperability endpoints
- jareddixon-mmfpas@direct.medalliesmail.com
- jamescooper-mmfpas@direct.medalliesmail.com
- lisabarker-mmfpas@direct.medalliesmail.com
- kristenwright-mmfpas@direct.medalliesmail.com
- kirkwatson-mmfpas@direct.medalliesmail.com
- josephmorgan-mmfpas@direct.medalliesmail.com
- evelyncathcart-mmfpas@direct.medalliesmail.com
- markalbey-mmfpas@direct.medalliesmail.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1304 Military Rd
Benton, AR 72015
Mailing address
1304 Military Rd
Benton, AR 72015
Phone (501) 778-0934
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110153002 | Medicaid | AR |
Other names
- Family Practice Associates
Other providers in Benton, AR
- Prime Medical Group PLLC
- Laura Prince
- Pro Active Rehab, Inc
- Promed Preferred Ar 2 Professional Corporation
- Keith Propps
- Erica Lynn Pruitt
- Matthew H Pruitt
- Kaley Prysock
- John Jeffrey Pugh
- Shara Purtle
All providers in Benton, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.