Active NPI
Lifespring Women's Healthcare PA
- Obstetrics & Gynecology Physician
- Bentonville, AR
National Provider Identifier
1164519450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- LIFESPRING WOMEN'S HEALTHCARE PA
- Practice address
- 1200 SE 28TH St
2
Bentonville, AR 72712-3881 - Phone
- (479) 271-0005
- Fax
- (479) 273-1427
- NPI assigned
- Oct 6, 2006
- Last updated
- Jul 8, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. J Todd Hannah, M.D.
- Title
- Owner
- Phone
- (479) 271-0005
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | Primary |
Addresses
Primary practice location
1200 SE 28TH St
2
Bentonville, AR 72712-3881
Mailing address
1200 SE 28TH St
2
Bentonville, AR 72712-3881
Phone (479) 271-0005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D2308420 | Lifespring Women's Healthcare | Provider-performed microscopy | Jul 28, 2026 |
National Provider Directory
National Provider DirectoryInteroperability endpoints
- https://fhir4.healow.com/fhir/r4/GAHCDA
Practitioners & affiliated clinicians
Practitioners 13
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.
-
- Obstetrics & Gynecology Physician
- Bentonville, AR
- NPI 1104210830
-
- Obstetrics & Gynecology Physician
- Bentonville, AR
- NPI 1245290535
-
- Obstetrics & Gynecology Physician
- Siloam Springs, AR
- NPI 1861503062
-
- Obstetrics & Gynecology Physician
- Bentonville, AR
- NPI 1104886761
-
- Obstetrics & Gynecology Physician
- Bentonville, AR
- NPI 1558709469
-
- Obstetrics & Gynecology Physician
- Bentonville, AR
- NPI 1821170481
-
- Obstetrics & Gynecology Physician
- Rogers, AR
- NPI 1053316745
-
- Obstetrics & Gynecology Physician
- Johnson, AR
- NPI 1215960471
-
- Obstetrics & Gynecology Physician
- Bentonville, AR
- NPI 1689323990
-
- Women's Health Nurse Practitioner
- Johnson, AR
- NPI 1790146454
-
- Obstetrics & Gynecology Physician
- Bentonville, AR
- NPI 1033081435
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1373241600000",
"number": "1164519450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 SE 28TH ST",
"address_2": "2",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727123881",
"telephone_number": "479-271-0005",
"fax_number": "473-273-1427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 SE 28TH ST",
"address_2": "2",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727123881",
"telephone_number": "479-271-0005",
"fax_number": "479-273-1427"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFESPRING WOMEN'S HEALTHCARE PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-06",
"last_updated": "2013-07-08",
"status": "A",
"authorized_official_last_name": "HANNAH",
"authorized_official_first_name": "J",
"authorized_official_middle_name": "TODD",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "479-271-0005",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.