Individual provider Active NPI

Judy H Trent, DO

  • Family Medicine Physician
  • Fort Smith, AR
National Provider Identifier
1396733788
Registry record updated Aug 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N7792 Issued in AR
Practice address
1500 Dodson Ave
Fort Smith, AR 72901-5182
Phone
(479) 441-2600
Fax
(479) 441-2895
NPI assigned
Oct 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2015

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 N7792 AR Primary

Addresses

Primary practice location

1500 Dodson Ave
Fort Smith, AR 72901-5182

Mailing address

PO Box 2406
Fort Smith, AR 72902-2406
Phone (479) 441-2600

Other identifiers 2

IdentifierTypeStateIssuer
100101500AMedicaidOK
116824003MedicaidAR

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2119OKMDRegistered Dietitian
N7792ARMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440201600000",
    "number": "1396733788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2406",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729022406",
            "telephone_number": "479-441-2600",
            "fax_number": "479-441-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DODSON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015182",
            "telephone_number": "479-441-2600",
            "fax_number": "479-441-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENT",
        "first_name": "JUDY",
        "middle_name": "H",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2015-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "N7792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100101500A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116824003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.