Individual provider Active NPI

David Julian Streett, M.D.

  • Psychiatry Physician
  • Benton, AR
National Provider Identifier
1427013846
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
E1489 Issued in AR
Practice address
100 Rivendell Dr
Benton, AR 72019-9188
Phone
(501) 316-1255
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X E1489 AR Primary

Addresses

Primary practice location

100 Rivendell Dr
Benton, AR 72019-9188

Mailing address

100 Rivendell Dr
Benton, AR 72019-9188
Phone (501) 316-1255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040701001555 AR Practitioner - Psychiatry 2163409640 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E1489ARMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs of Benton, LLC CurrentSince Feb 5, 2014 Accepting new patients

Locations

100 Rivendell Dr
Benton, AR 72019
Phone (501) 316-1255

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1427013846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIVENDELL DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720199188",
            "telephone_number": "501-316-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIVENDELL DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720199188",
            "telephone_number": "501-316-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREETT",
        "first_name": "DAVID",
        "middle_name": "JULIAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "E1489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.