Individual provider Active NPI

Consuella Roxanne Flurry, MS, PT

  • Physical Therapist
  • Clarksville, AR
National Provider Identifier
1447282850
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2248 Issued in AR
Practice address
112 S Fulton St
Clarksville, AR 72830-3612
Phone
(479) 754-4060
Fax
(479) 754-4060
NPI assigned
Jul 7, 2006
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2248 AR Primary
Physical Therapist 225100000X 2248 AR

Addresses

Primary practice location

112 S Fulton St
Clarksville, AR 72830-3612

Mailing address

112 S Fulton St
Clarksville, AR 72830-3612
Phone (479) 754-4060

Other identifiers 1

IdentifierTypeStateIssuer
137064721MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120228000016 AR Practitioner - Physical Therapist in Private Practice 9335307024 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2248ARMDPhysical Therapist
PT2248ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Little Angels Therapy and Women's Wellness Center, Inc. CurrentSince Jan 24, 2012 Accepting new patients

Locations

112 S Fulton St
Clarksville, AR 72830
Phone (479) 754-4060

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1447282850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S FULTON ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303612",
            "telephone_number": "479-754-4060",
            "fax_number": "479-754-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S FULTON ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303612",
            "telephone_number": "479-754-4060",
            "fax_number": "479-754-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLURRY",
        "first_name": "CONSUELLA",
        "middle_name": "ROXANNE",
        "name_prefix": "Mrs.",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT2248",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "2248",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137064721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.