Individual provider Active NPI

Damon Sturdivant, DPT

  • Physical Therapist
  • El Dorado, AR
National Provider Identifier
1336527811
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3517 Issued in AR
Practice address
2700 Vine St
El Dorado, AR 71730-6700
Phone
(870) 875-5124
Fax
(870) 875-5198
NPI assigned
May 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT3517 AR Primary

Addresses

Primary practice location

2700 Vine St
El Dorado, AR 71730-6700

Mailing address

2700 Vine St
El Dorado, AR 71730-6700
Phone (870) 875-5124

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812007216 AR Practitioner - Physical Therapist in Private Practice 1254646813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2700 Vine St
El Dorado, AR 71730-6700
Phone (870) 862-1144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT3517ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Arkansas Orthopaedics and Sports Medicine Center PLLC CurrentSince Jul 16, 2025 Accepting new patients
Hill & Ironside LTD Physical Therapist CurrentSince Sep 13, 2021 Accepting new patients
Medical Associates of Northwest Arkansas PA Past Accepting new patients

Locations

642 W Lancashire Blvd
Bella Vista, AR 72715
Phone (479) 876-6686

2700 Vine St
El Dorado, AR 71730
Phone (870) 862-1144

201 S 19th St
Ste S
Rogers, AR 72758
Phone (479) 631-3955

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1336527811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 VINE ST",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717306700",
            "telephone_number": "870-875-5124",
            "fax_number": "870-875-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 VINE ST",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717306700",
            "telephone_number": "870-875-5124",
            "fax_number": "870-875-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURDIVANT",
        "first_name": "DAMON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-15",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT3517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.