Individual provider Active NPI

Patrick D Fields, D.D.S.

  • General Practice Dentistry
  • Cabot, AR
National Provider Identifier
1467476564
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3417 Issued in AR
Practice address
24 Spring St
Suite a
Cabot, AR 72023-2473
Phone
(501) 941-2482
Fax
(501) 941-2483
NPI assigned
Jul 26, 2006
Last updated
Oct 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3417 AR Primary

Addresses

Primary practice location

24 Spring St
Suite a
Cabot, AR 72023-2473

Mailing address

24 Spring St
Suite a
Cabot, AR 72023-2473
Phone (501) 941-2482

Other identifiers 1

IdentifierTypeStateIssuer
149020608MedicaidAR

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151217001093 AR Order and Referring Only - DentistPractitioner - Dentist 8921309865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3417ARMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1467476564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SPRING ST",
            "address_2": "SUITE A",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720232473",
            "telephone_number": "501-941-2482",
            "fax_number": "501-941-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 SPRING ST",
            "address_2": "SUITE A",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720232473",
            "telephone_number": "501-941-2482",
            "fax_number": "501-941-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "PATRICK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149020608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabot, AR

Sources for this page

Verify at the official NPI Registry.