Active NPI
Thomas Jeremy Priest
- Physical Therapy Assistant
- Greenwood, AR
National Provider Identifier
1366084451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4474
- Practice address
- 618 W Center St
Greenwood, AR 72936-4605 - Phone
- (479) 996-2525
- NPI assigned
- Oct 10, 2019
- 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 Therapy Assistant | 225200000X | 4474 | AR | Primary |
Addresses
Primary practice location
618 W Center St
Greenwood, AR 72936-4605
Mailing address
40 Tok JCT
Oden, AR 71961-8148
Phone (479) 234-1147
Other practice location 1
40 Tok Jct
Oden, AR 71961-8148
Phone (479) 234-1147
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4474 | AR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCL Therapy LLC | Current | Accepting new patients | |
| Bohannan Irgens Group LLC | Past | Accepting new patients |
Locations
618 W Center St
Greenwood, AR 72936
Phone (479) 996-2525
Organizations & group practices 2
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.
-
- Physical Therapy Clinic/Center
- Greenwood, AR
- NPI 1154692481
-
- Physical Therapy Clinic/Center
- Greenwood, AR
- NPI 1417313925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570665600000",
"number": "1366084451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 TOK JCT",
"city": "ODEN",
"state": "AR",
"postal_code": "719618148",
"telephone_number": "479-234-1147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 W CENTER ST",
"city": "GREENWOOD",
"state": "AR",
"postal_code": "729364605",
"telephone_number": "479-996-2525"
}
],
"practiceLocations": [
{
"address_1": "40 Tok Jct",
"address_purpose": "LOCATION",
"city": "Oden",
"state": "AR",
"postal_code": "719618148",
"country_code": "US",
"telephone_number": "479-234-1147",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRIEST",
"first_name": "THOMAS",
"middle_name": "JEREMY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-10",
"last_updated": "2019-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AR",
"license": "4474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenwood, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.