NPIMap

Organization Active NPI

Saline County Physical Therapy

  • Physical Therapy Clinic/Center
  • Benton, AR
National Provider Identifier
1164437646
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SALINE COUNTY PHYSICAL THERAPY
Practice address
1115 Ferguson Dr
Benton, AR 72015-3512
Phone
(501) 315-0639
Fax
(501) 315-7278
NPI assigned
Jul 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Mr. Randall Green, PT
Title
Owner
Phone
(501) 315-0639

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1115 Ferguson Dr
Benton, AR 72015-3512

Mailing address

1115 Ferguson Dr
Benton, AR 72015-3512
Phone (501) 315-0639

Other identifiers 1

IdentifierTypeStateIssuer
117948742MedicaidAR

National Provider Directory

National Provider Directory

Locations

1115 Ferguson Dr
Benton, AR 72015
Phone (501) 315-0639

Practitioners & affiliated clinicians

Practitioners 4

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": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1164437646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 FERGUSON DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153512",
            "telephone_number": "501-315-0639",
            "fax_number": "501-315-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 FERGUSON DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153512",
            "telephone_number": "501-315-0639",
            "fax_number": "501-315-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALINE COUNTY PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-315-0639",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117948742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.