Individual provider Active NPI

Ronald K Brimberry, MD

  • Family Medicine Physician
  • Springdale, AR
National Provider Identifier
1336129758
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C-6028 Issued in AR
Practice address
601 W Maple Ave
Suite 102
Springdale, AR 72764-5379
Phone
(479) 750-6585
Fax
(479) 750-6594
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C-6028 AR Primary

Addresses

Primary practice location

601 W Maple Ave
Suite 102
Springdale, AR 72764-5379

Mailing address

601 W Maple Ave
Suite 102
Springdale, AR 72764-5379
Phone (479) 750-6585

Other identifiers 8

IdentifierTypeStateIssuer
105374001MedicaidAR
390702OtherARHEALTHLINK
971868OtherARFIRST HEALTH
080153473OtherARRAILROAD MEDICARE
1353054OtherARUNITED HEALTH CARE
11671000000OtherARQUAL CHOICE
50638OtherARBCBS
5498573OtherARAETNA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050405001148 AR Practitioner - Family Practice 8820045453 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, shared by 29 NPIs, 1,159 clinicians

Practice addresses (Care Compare)

1125 N College Ave
Fayetteville, AR 72703-1908
Phone (479) 521-8260

601 W Maple Ave
Springdale, AR 72764-5370
Phone (479) 750-6585

Hospital & facility affiliations

  • Circle of Life Hospice Hospice, Springdale, AR, CCN 041529
  • University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016
  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004
  • Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022
  • Arkansas Veterans Home at Fayetteville Nursing home, Fayetteville, AR, CCN 045417

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-6028ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System Family Medicine CurrentSince Apr 1, 2015 Accepting new patients
Washington Regional Medical System CurrentSince Apr 1, 2015 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jun 1, 2000 Accepting new patients
South Arkansas Emergency Physicians, LLP CurrentSince Jan 6, 2014 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jun 1, 2000 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jun 1, 2000 Accepting new patients
South Arkansas Emergency Physicians LLP Current Accepting new patients
South Arkansas Emergency Physicians, LLP CurrentSince Jan 6, 2014 Accepting new patients
Washington Regional Medical System Family Medicine Current Accepting new patients
Washington Regional Medical System Family Medicine CurrentSince Apr 1, 2015 Accepting new patients
QHG of Springdale Inc Past Accepting new patients
University of Arkansas for Medical Sciences Family Medicine Past Accepting new patients

Locations

1125 N College Ave
Fayetteville, AR 72703
Phone (479) 521-8260

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

601 W Maple Ave
Ste 102
Springdale, AR 72764
Phone (479) 750-6585

Interoperability endpoints

  • Direct secure messaging: rbrimberry50184@washingtonregional.direct-ci.com

Organizations & group practices 12

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.

Hospital & facility affiliations 5

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1336129758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W MAPLE AVE",
            "address_2": "SUITE 102",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645379",
            "telephone_number": "479-750-6585",
            "fax_number": "479-750-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W MAPLE AVE",
            "address_2": "SUITE 102",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645379",
            "telephone_number": "479-750-6585",
            "fax_number": "479-750-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIMBERRY",
        "first_name": "RONALD",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C-6028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105374001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "390702",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "971868",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080153473",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1353054",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAL CHOICE",
            "identifier": "11671000000",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "50638",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5498573",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.