Western Arkansas Plastic & Reconstructive Surgery Center

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

E0847 Issued in AR

Legal business name

WESTERN ARKANSAS PLASTIC & RECONSTRUCTIVE SURGERY CENTER

Practice address

8101 McClure Dr Ste 301
Fort Smith, AR 72916-6056

Phone

(479) 709-8300

Fax

(479) 709-8315

NPI assigned

Jul 29, 2006

Organization subpart

No

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

Authorized official

Name

James E Kelly III, M.D.NPI 1144289331

Title

Owner

Phone

(479) 709-8300

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

Locations

Practitioners 2

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

• James E. Kelly III, M.D.

  • Surgery of the Hand (Plastic Surgery) Physician
  • Fort Smith, AR
  • NPI 1144289331
  Medicare reassignment Care Compare group NPD Authorized official
• Ashley Nicole Tucker

  • Family Nurse Practitioner
  • Fort Smith, AR
  • NPI 1679151609
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1194730077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10810",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729170810",
            "telephone_number": "479-709-8300",
            "fax_number": "479-709-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 MCCLURE DR STE 301",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729166056",
            "telephone_number": "479-709-8300",
            "fax_number": "479-709-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN ARKANSAS PLASTIC & RECONSTRUCTIVE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-709-8300",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "AR",
            "license": "E0847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130121001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000480A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Western Arkansas Counseling and Guidance Center, Inc.
• Western Arkansas Heart Lung & Vascular Surgical Associates
• Western Arkansas Medical Associates
• Western Arkansas Medical LLC
• Western Arkansas Obstetric Anesthesia LLC
• Western Arkansas Surgical Center
• Brett D Whatcott, DO
• Wheeler Avenue Operating LLC
• Danielle E Wheeler, LPC, LMFT
• John Wheeler

• Plastic Surgery Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Plastic Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.