Individual provider Active NPI

Cynthia K Ashcraft, MD

  • Pediatrics Physician
  • Fort Smith, AR
National Provider Identifier
1306833215
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C6785 Issued in AR
Practice address
1501 S Waldron Rd
Ste 100
Fort Smith, AR 72903-2574
Phone
(479) 709-7337
Fax
(479) 709-7461
NPI assigned
Oct 5, 2005
Last updated
Aug 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C6785 AR Primary

Addresses

Primary practice location

1501 S Waldron Rd
Ste 100
Fort Smith, AR 72903-2574

Mailing address

PO Box 402330
Atlanta, GA 30384-2330
Phone (479) 709-7399

Other identifiers 2

IdentifierTypeStateIssuer
100077910AMedicaidOK
114495001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20161219001569 TX Practitioner - Pediatric Medicine 4688634645 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C6785ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Oct 22, 2016 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Oct 22, 2016 Accepting new patients
Choctaw Nation of Oklahoma Past Accepting new patients
Sparks Medical Foundation Past Accepting new patients

Locations

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

Interoperability endpoints

  • Direct secure messaging: cashcraft19657@choctawnation.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1306833215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402330",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842330",
            "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": "1501 S WALDRON RD",
            "address_2": "STE 100",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032574",
            "telephone_number": "479-709-7337",
            "fax_number": "479-709-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHCRAFT",
        "first_name": "CYNTHIA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "C6785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100077910A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114495001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.