NPIMap

Organization Active NPI

Physical Therapy Center of South Arkansas Inc

  • Physical Therapy Clinic/Center
  • El Dorado, AR
National Provider Identifier
1194892406
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT2026 Issued in AR
Legal business name
PHYSICAL THERAPY CENTER OF SOUTH ARKANSAS INC
Practice address
215 N Newton Ave
El Dorado, AR 71730-5421
Phone
(870) 863-5100
Fax
(870) 863-5102
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jared Clinton Rhodes, MS PTNPI 1902973217
Title
Owner President
Phone
(870) 863-5100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT2026 AR Primary

Addresses

Primary practice location

215 N Newton Ave
El Dorado, AR 71730-5421

Mailing address

215 N Newton Ave
El Dorado, AR 71730-5421
Phone (870) 863-5100

Other identifiers 2

IdentifierTypeStateIssuer
DC1211OtherARMEDICARE RAILROAD
5F055OtherARBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610001824 AR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9234112129 Receives reassigned benefits from 3 practitioners
Practice locations: El Dorado, AR

National Provider Directory

National Provider Directory

Locations

215 N Newton Ave
El Dorado, AR 71730
Phone (870) 863-5100

600 S Timberlane Dr
Ste B
El Dorado, AR 71730
Phone (870) 862-6000

Practitioners 7

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": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194892406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N NEWTON AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717305421",
            "telephone_number": "870-863-5100",
            "fax_number": "870-863-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N NEWTON AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717305421",
            "telephone_number": "870-863-5100",
            "fax_number": "870-863-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY CENTER OF SOUTH ARKANSAS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RHODES",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "CLINTON",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "870-863-5100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "AR",
            "license": "PT2026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DC1211",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5F055",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.