NPIMap

Organization Active NPI

Ozark Regional Anesthesia

  • Anesthesiology Physician
  • Fayetteville, AR
National Provider Identifier
1275517468
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
OZARK REGIONAL ANESTHESIA
Practice address
3215 N Northhills Blvd
Fayetteville, AR 72703-4424
Phone
(479) 463-1019
NPI assigned
Dec 1, 2005
Last updated
Feb 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Authorized official

Name
Thomas Jay Davis, MD
Title
President
Phone
(918) 728-6145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

3215 N Northhills Blvd
Fayetteville, AR 72703-4424

Mailing address

PO Box 1867
Fayetteville, AR 72702-1867
Phone (918) 664-9892

Other identifiers 2

IdentifierTypeStateIssuer
100728380AMedicaidOK
135928002MedicaidAR

National Provider Directory

National Provider Directory

Locations

133 W Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 442-3961

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1275517468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1867",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021867",
            "telephone_number": "918-664-9892",
            "fax_number": "918-664-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 N NORTHHILLS BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034424",
            "telephone_number": "479-463-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARK REGIONAL ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-728-6145",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100728380A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135928002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.