Arkansas PHS PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ARKANSAS PHS PA

Practice address

609 SW 8TH Street
Suite 600
Bentonville, AR 72712-8913

Phone

(901) 261-4848

Fax

(901) 261-4849

NPI assigned

Aug 3, 2009

Organization subpart

Yes

Parent organization

PROVIDER HEALTH SERVICES LLCAs reported in NPPES

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

Authorized official

Name

Nicole Howard

Title

Cfo

Phone

(337) 991-9276

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1194956516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 DULLES DRIVE",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70506",
            "telephone_number": "337-991-9276",
            "fax_number": "337-991-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 SW 8TH STREET",
            "address_2": "SUITE 600",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128913",
            "telephone_number": "901-261-4848",
            "fax_number": "901-261-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS PHS PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDER HEALTH SERVICES LLC",
        "enumeration_date": "2009-08-03",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "337-991-9276"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190440762",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arkansas Dental Health Professionals, Mongrain, P.a.
• Arkansas Liver and Gastroenterology, P.a.
• Arkansas Medical & Wellness PA
• Arkansas MRI Services LLC
• Arkansas Muscle & Joint Clinic, LLC
• Arkansas Urology, P.a.
• James H Arkins, MD
• Amanda K Arnold, MHPP
• Madison Arnold
• Ascension Group Holdings LLC

• Family Medicine Physician in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.