NPIMap

Organization Active NPI

Southern Arkansas University

Doing business as Southern Arkansas University Sports Medicine

  • Sports Medicine (Family Medicine) Physician
  • Magnolia, AR
National Provider Identifier
1144623679
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
SOUTHERN ARKANSAS UNIVERSITY
Doing business as
Southern Arkansas University Sports Medicine
Practice address
100 E University
Magnolia, AR 71753-2181
Phone
(870) 235-4142
Fax
(870) 235-4988
NPI assigned
Sep 29, 2014
Last updated
Oct 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Authorized official

Name
David F Rankin
Title
Univeristy President
Phone
(870) 235-4142

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X Primary

Addresses

Primary practice location

100 E University
Magnolia, AR 71753-2181

Mailing address

100 E University
Magnolia, AR 71753-2181
Phone (870) 235-4142

Other names 1

  • Southern Arkansas University Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Arkansas University2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1144623679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E UNIVERSITY",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532181",
            "telephone_number": "870-235-4142",
            "fax_number": "870-235-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E UNIVERSITY",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532181",
            "telephone_number": "870-235-4142",
            "fax_number": "870-235-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ARKANSAS UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "RANKIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "UNIVERISTY PRESIDENT",
        "authorized_official_telephone_number": "870-235-4142"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Arkansas University Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Magnolia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.