Urology Group of Western Arkansas

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

UROLOGY GROUP OF WESTERN ARKANSAS

Practice address

5500 Ellsworth Rd.
Fort Smith, AR 72903-3222

Phone

(479) 242-2411

Fax

(479) 242-2412

NPI assigned

Jan 27, 2006

Last updated

Mar 23, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Lange, M.D.NPI 1154382802

Title

President

Phone

(479) 709-7416

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 2

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.

• John Leslie Lange, M.D.

  • Urology Physician
  • Fort Smith, AR
  • NPI 1154382802
  Authorized official Same address or phone
• Tracy R Harwood, APRN

  • Family Nurse Practitioner
  • Fort Smith, AR
  • NPI 1790926475
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1326019506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 758",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729020758",
            "telephone_number": "479-709-7416",
            "fax_number": "479-709-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 ELLSWORTH RD.",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729033222",
            "telephone_number": "479-242-2411",
            "fax_number": "479-242-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY GROUP OF WESTERN ARKANSAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "LANGE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-709-7416",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200027500A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5F080",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154225002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• University of Arkansas for Medical Sciences (AHEC Family Medical Center)
• University of Arkansas for Medical Sciences
• Upchurch Holdings (Life Therapeutic)
• Peyton Upchurch
• Urologic Specialists of Oklahoma Inc (Urologic Specialists of Arkansas, P.A.)
• Muhammad Usman, M.D.
• Denise Valentin, R.N.P.
• Luis Ernsto Valle
• Valley Group, PLLC (Valley Health Care)
• Valley River Nursing, LLC (River Valley Health & Rehabilitation Center)

• Urology Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Urology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.