NPIMap

Organization Active NPI

South Arkansas Orthopaedics and Sports Medicine Center PLLC

Doing business as South Arkansas Orthopaedics

  • Specialist
  • El Dorado, AR
National Provider Identifier
1407845951
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SOUTH ARKANSAS ORTHOPAEDICS AND SPORTS MEDICINE CENTER PLLC
Doing business as
South Arkansas Orthopaedics
Practice address
2700 Vine St
El Dorado, AR 71730-6700
Phone
(870) 862-1144
Fax
(870) 864-0782
NPI assigned
Oct 18, 2005
Last updated
Dec 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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

Authorized official

Name
Mrs. Kathey D Jones
Title
Office Manager
Phone
(870) 862-1144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

2700 Vine St
El Dorado, AR 71730-6700

Mailing address

PO Box 10730
El Dorado, AR 71730-0028
Phone (870) 862-1144

Other identifiers 4

IdentifierTypeStateIssuer
200039405OtherARUNITED/RAILROAD MEDICARE
141689002MedicaidAR
200031980OtherARUNITED/RAILROAD MEDICARE
200039406OtherARUNITED/RAILROAD MEDICARE

Other names 1

  • South Arkansas Orthopaedics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080219000744 AR Part B Supplier - Clinic/Group Practice 2769566470 Receives reassigned benefits from 5 practitioners
Practice locations: El Dorado, AR

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

704 W Grove St
Ste 5
El Dorado, AR 71730
Phone (870) 862-1144

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228089600000",
    "number": "1407845951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10730",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717300028",
            "telephone_number": "870-862-1144",
            "fax_number": "870-864-0782"
        },
        {
            "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": "870-862-1144",
            "fax_number": "870-864-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ARKANSAS ORTHOPAEDICS AND SPORTS MEDICINE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2008-12-01",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KATHEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-862-1144",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED/RAILROAD MEDICARE",
            "identifier": "200039405",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141689002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED/RAILROAD MEDICARE",
            "identifier": "200031980",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED/RAILROAD MEDICARE",
            "identifier": "200039406",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Arkansas Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 1, 2008; 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.