Individual provider Active NPI

Frederick Nicholas Day III, DPM

  • Foot & Ankle Surgery Podiatrist
  • Gravette, AR
National Provider Identifier
1275736340
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
147 Issued in AR
Practice address
1101 Jackson St SW
Gravette, AR 72736-9121
Phone
(479) 334-6870
NPI assigned
Jun 7, 2007
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 147 AR
Foot & Ankle Surgery Podiatrist 213ES0103X 147 AR Primary

Addresses

Primary practice location

1101 Jackson St SW
Gravette, AR 72736-9121

Mailing address

3914 Belle Mead St
Springdale, AR 72762-8251
Phone (609) 402-1066

Other practice location 1

125 Main St
Noel, MO 64854-9124
Phone (417) 475-6151

Other practice location 2

1355 Rocketdyne Rd
Neosho, MO 64850-3106
Phone (417) 451-7425

Other practice location 3

109 N Broadway St
South West City, MO 64863-9417
Phone (417) 762-3287

Other practice location 4

102 Russell Rd
Rogers, AR 72756-9319
Phone (417) 278-7189

Other identifiers 2

IdentifierTypeStateIssuer
127988717MedicaidAR
P01158251OtherARMEDICARE TRA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080514000444 AR Practitioner - Podiatry 5193635779 Reassigns benefits to 2 organizations
Practice locations: Springdale, AR
I20210604000898 MO Practitioner - Podiatry 5193635779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sgoh Acquisition IncGroup PAC ID 5092616276, shared by 16 NPIs, 95 clinicians

Practice addresses (Care Compare)

1101 Jackson St SW
Gravette, AR 72736-9121
Phone (479) 787-5291

1355 Rocketdyne Rd
Neosho, MO 64850-3106
Phone (417) 451-7425

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1223TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sgoh Acquisition Inc CurrentSince Mar 5, 2021 Accepting new patients
Sgoh Acquisition Inc Podiatrist CurrentSince Sep 21, 2020 Accepting new patients
Sgoh Acquisition Inc CurrentSince Sep 21, 2020 Accepting new patients
Preferred Podiatry Group PC Podiatrist Past Accepting new patients

Locations

1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221

102 Russell Rd
Rogers, AR 72756
Phone (479) 278-7189

106 S Hickory St
Mount Vernon, MO 65712
Phone (417) 466-4110

117 E Hickory St
Neosho, MO 64850
Phone (417) 451-4545

1355 Rocketdyne Rd
Neosho, MO 64850
Phone (417) 451-2240

125 Main St
Noel, MO 64854
Phone (417) 475-6151

109 N Broadway St
South West Cy, MO 64863
Phone (417) 752-3287

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1275736340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3914 BELLE MEAD ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727628251",
            "telephone_number": "609-402-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 JACKSON ST SW",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369121",
            "telephone_number": "479-334-6870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Main St",
            "address_purpose": "LOCATION",
            "city": "Noel",
            "state": "MO",
            "postal_code": "648549124",
            "country_code": "US",
            "telephone_number": "417-475-6151",
            "fax_number": "417-475-6559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1355 Rocketdyne Rd",
            "address_purpose": "LOCATION",
            "city": "Neosho",
            "state": "MO",
            "postal_code": "648503106",
            "country_code": "US",
            "telephone_number": "417-451-7425",
            "fax_number": "417-451-7455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "South West City",
            "state": "MO",
            "postal_code": "648639417",
            "country_code": "US",
            "telephone_number": "417-762-3287",
            "fax_number": "417-762-3255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 Russell Rd",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727569319",
            "country_code": "US",
            "telephone_number": "417-278-7189",
            "fax_number": "417-278-2199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAY",
        "first_name": "FREDERICK",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AR",
            "license": "147",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AR",
            "license": "147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127988717",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TRA",
            "identifier": "P01158251",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gravette, AR

Sources for this page

Verify at the official NPI Registry.