Individual provider Active NPI

Samuel H Arnold III, D O

  • Surgery Physician
  • Warren, AR
National Provider Identifier
1164416640
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
E-2458 Issued in AR
Practice address
404 S Bradley St
Warren, AR 71671-3459
Phone
(870) 226-3731
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20060510000030 AR Practitioner - General Surgery 0042221780 Reassigns benefits to 4 organizations
Practice locations: Camden, AR

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Ouachita County Medical Center Current
since Jan 12, 2019
Accepting new patients
Bradley County Medical Center Current
since Aug 28, 2023
Accepting new patients
Ouachita Physician Services, LLC Surgery Current
since Mar 22, 2017
Accepting new patients
Bradley County Medical Center Current
since Sep 1, 2025
Accepting new patients
Ouachita Physician Services Current
since Mar 22, 2017
Accepting new patients
Bradley County Medical Center Current
since Sep 1, 2025
Accepting new patients
Drew Surgical Services LLC Surgery Current
since Sep 1, 2022
Accepting new patients
Ouachita County Medical Center Current
since Jan 12, 2019
Accepting new patients
Bradley County Medical Center Current
since Aug 28, 2023
Accepting new patients
McLean & D G Clinic Past Accepting new patients

Locations

415 Hospital Dr
Ste 3
Camden, AR 71701
Phone (260) 415-5387

476 Hospital Dr
Camden, AR 71701
Phone (870) 800-9002

638 California Ave SW
East Camden, AR 71701
Phone (870) 836-1000

778 Scogin Dr
Spc Llc
Monticello, AR 71655
Phone (870) 460-3515

778 Scogin Dr
Monticello, AR 71655
Phone (870) 367-2411

404 S Bradley St
Warren, AR 71671
Phone (870) 226-3731

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/bradley-49d5c27e

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X E-2458 AR Primary

Addresses

NPPES NPI Registry

Primary practice location

404 S Bradley St
Warren, AR 71671-3459

Mailing address

1316 S Highway 7
Sparkman, AR 71763-8674
Phone (870) 807-4255

Other identifiers 6

NPPES NPI Registry
IdentifierTypeStateIssuer
1164416640OtherQUALCHOICE
5181488OtherAETNA
141442003MedicaidAR
207122OtherHEALTHLINK
0000129360506OtherUNITED HEALTH CARE
020053473OtherRAILROAD MEDICARE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 25, 2024.

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1164416640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 S HIGHWAY 7",
            "city": "SPARKMAN",
            "state": "AR",
            "postal_code": "717638674",
            "telephone_number": "870-807-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S BRADLEY ST",
            "city": "WARREN",
            "state": "AR",
            "postal_code": "716713459",
            "telephone_number": "870-226-3731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "SAMUEL",
        "middle_name": "H",
        "name_suffix": "III",
        "credential": "D O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-2458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "1164416640",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5181488",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141442003",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "207122",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0000129360506",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020053473",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, AR

Sources for this page

Verify at the official NPI Registry.