Active NPI
Damon Sturdivant, DPT
- Physical Therapist
- El Dorado, AR
National Provider Identifier
1336527811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT3517
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT3517 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Arkansas Orthopaedics and Sports Medicine Center PLLC | Current | Accepting new patients | |
| Hill & Ironside LTD | Physical Therapist | Current | 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.
-
- Specialist
- El Dorado, AR
- NPI 1407845951
-
- Physical Therapist
- Bentonville, AR
- NPI 1932215084
-
- Family Medicine Physician
- Springdale, AR
- NPI 1831149582
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.