Organization Active NPI

Arkansas Foot & Ankle Clinic, PA

Doing business as Bryant Foot & Ankle Clinic

  • Foot & Ankle Surgery Podiatrist
  • Pine Bluff, AR
National Provider Identifier
1346534047
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
162 Issued in AR
Legal business name
ARKANSAS FOOT & ANKLE CLINIC, PA
Doing business as
Bryant Foot & Ankle Clinic
South Arkansas Foot & Ankle Clinic
Practice address
1801 W 40TH Ave
Suite 4E
Pine Bluff, AR 71603-6940
Phone
(870) 535-4850
Fax
(870) 535-3558
NPI assigned
May 31, 2011
Last updated
Oct 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Dr. John P ThrashNPI 1811973225
Title
Doctor
Phone
(870) 535-4850

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 162 AR Primary

Addresses

Primary practice location

1801 W 40TH Ave
Suite 4E
Pine Bluff, AR 71603-6940

Mailing address

1801 W 40TH Ave
Suite 4E
Pine Bluff, AR 71603-6940
Phone (870) 535-4850

Other identifiers 6

IdentifierTypeStateIssuer
2720022OtherARUNITED HEALTHCARE
17389000000OtherARQUAL CHOICE
5T328OtherARBLUE CROSS AND BLUE SHIELD
130021717MedicaidAR
480021446OtherARPALMETTO
4249008OtherARAETNA

Other names 2

  • Bryant Foot & Ankle Clinic Doing business as
  • South Arkansas Foot & Ankle Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110613000787 AR Part B Supplier - Clinic/Group Practice 3274710587 Receives reassigned benefits from 1 practitioner
Practice locations: Pine Bluff, AR

National Provider Directory

National Provider Directory

Locations

1801 W 40th Ave
Ste 4E
Pine Bluff, AR 71603
Phone (870) 535-4850

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1346534047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W 40TH AVE",
            "address_2": "SUITE 4E",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036940",
            "telephone_number": "870-535-4850",
            "fax_number": "870-535-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W 40TH AVE",
            "address_2": "SUITE 4E",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036940",
            "telephone_number": "870-535-4850",
            "fax_number": "870-535-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS FOOT & ANKLE CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-31",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "THRASH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "870-535-4850",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AR",
            "license": "162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2720022",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAL CHOICE",
            "identifier": "17389000000",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "5T328",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130021717",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "480021446",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4249008",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bryant Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Arkansas Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.