NPIMap

Organization Active NPI

Boston Mountain Healthcare Services Inc.

  • Physical Therapist
  • Ozark, AR
National Provider Identifier
1144249103
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 2698 Issued in AR
Legal business name
BOSTON MOUNTAIN HEALTHCARE SERVICES INC.
Practice address
257 Airport Rd
Ste. E
Ozark, AR 72949-9200
Phone
(479) 667-3710
Fax
(479) 667-3712
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Authorized official

Name
Brady T McCollum, DPT
Title
Physical Therapist
Phone
(479) 667-3710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT 2698 AR Primary

Addresses

Primary practice location

257 Airport Rd
Ste. E
Ozark, AR 72949-9200

Mailing address

257 Airport Rd
Ste. E
Ozark, AR 72949-9200
Phone (479) 667-3710

Other names 1

  • Ozark Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060222000562 AR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5991711319 Receives reassigned benefits from 1 practitioner
Practice locations: Ozark, AR

National Provider Directory

National Provider Directory

Locations

912 S Rogers St
Clarksville, AR 72830
Phone (479) 754-5600

257 Airport Rd
Ste E
Ozark, AR 72949
Phone (479) 667-3710

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1144249103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 AIRPORT RD",
            "address_2": "STE. E",
            "city": "OZARK",
            "state": "AR",
            "postal_code": "729499200",
            "telephone_number": "479-667-3710",
            "fax_number": "479-667-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 AIRPORT RD",
            "address_2": "STE. E",
            "city": "OZARK",
            "state": "AR",
            "postal_code": "729499200",
            "telephone_number": "479-667-3710",
            "fax_number": "479-667-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON MOUNTAIN HEALTHCARE SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "MCCOLLUM",
        "authorized_official_first_name": "BRADY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "479-667-3710",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT 2698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ozark Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ozark, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.