Von Phomakay, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E0767 Issued in AR

Practice address

5111 Rogers Ave
Ste 40M
Fort Smith, AR 72903-2047

Phone

(479) 709-7440

Fax

(479) 709-7441

NPI assigned

Oct 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Oklahoma State University College of Osteopathic Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Health ServicesGroup PAC ID 0648514133, 103 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055
• Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vphomakay241716@direct.baptist-healthar.org

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

• Baptist Health Services

  • Foot & Ankle Surgery Podiatrist
  • Fort Smith, AR
  • NPI 1922587690
  Medicare reassignment Care Compare group NPD
• Baptist Health Services

  • Family Medicine Physician
  • Fort Smith, AR
  • NPI 1750856043
  NPD
• Fort Smith Hma, LLC

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1578555736
  NPD (past)
• Sparks Medical Foundation

  • Family Medicine Physician
  • Fort Smith, AR
  • NPI 1932204369
  NPD (past)
• Sparks Regional Medical Center

  • Skilled Nursing Facility
  • Fort Smith, AR
  • NPI 1992916308
  NPD (past)

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

• Baptist Health

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1043240682
  Care Compare affiliation
• Baptist Health Regional Hospitals

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1710463146
  Care Compare affiliation

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1306833116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402319",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842319",
            "telephone_number": "479-709-7399",
            "fax_number": "479-709-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 ROGERS AVE",
            "address_2": "STE 40M",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032047",
            "telephone_number": "479-709-7440",
            "fax_number": "479-709-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOMAKAY",
        "first_name": "VON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E0767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100075480A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129386003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanner Philpot, MHPP/QBHP
• Phoenix Anesthesia PA
• Phoenix Health Associates of Fort Smith
• Phoenix Mobile Physical Therapy LLC
• Chansamone M Phomakay, MD
• Alisa Phommavong
• Cherrie Phouthavong
• Kaylee Lauren Pickartz, BCBA
• Randelle Pickens
• Gena Pierce, MD, RDN, LDN

• Family Medicine Physician in Fort Smith, AR
• Providers in Fort Smith, 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 Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.