NPIMap

Organization Active NPI

Oldenberg Inc

  • Family Medicine Physician
  • Cherokee Village, AR
National Provider Identifier
1215239702
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R3890 Issued in AR
Legal business name
OLDENBERG INC
Practice address
1 West Cherokee Village Mall
Cherokee Village, AR 72529
Phone
(870) 257-4110
Fax
(870) 257-4112
NPI assigned
Dec 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Authorized official

Name
Denise Oldenberg, M.D.NPI 1538137500
Title
President
Phone
(870) 257-4110

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X R3890 AR Primary

Addresses

Primary practice location

1 West Cherokee Village Mall
Cherokee Village, AR 72529

Mailing address

PO Box 249
Salem, AR 72576
Phone (870) 257-4110

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1215239702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "SALEM",
            "state": "AR",
            "postal_code": "72576",
            "telephone_number": "870-257-4110",
            "fax_number": "870-257-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WEST CHEROKEE VILLAGE MALL",
            "city": "CHEROKEE VILLAGE",
            "state": "AR",
            "postal_code": "72529",
            "telephone_number": "870-257-4110",
            "fax_number": "870-257-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLDENBERG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "OLDENBERG",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-257-4110",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "R3890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherokee Village, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.