Marty Hurlbut, M.D., PA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

N8015 Issued in AR

Legal business name

MARTY HURLBUT, M.D., PA

Practice address

153 E Monte Painter Dr
Fayetteville, AR 72703-4002

Phone

(479) 444-2207

Fax

(479) 444-2381

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Martin Hurlbut, M.D.NPI 1730183492

Title

President/Owner

Phone

(479) 444-2207

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Martin Hurlbut, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Fayetteville, AR
  • NPI 1730183492
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1467670802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8638",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727030011",
            "telephone_number": "479-444-2207",
            "fax_number": "479-444-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 E MONTE PAINTER DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034002",
            "telephone_number": "479-444-2207",
            "fax_number": "479-444-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTY HURLBUT, M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "HURLBUT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "479-444-2207",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AR",
            "license": "N8015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117736001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146527002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William C Martin, MD
• Blakelyn Martindale
• Gustavo Kennedy Martinez, PT, DPT
• Jenny Martinez
• Joselyn Alexandra Martinez
• Jasmen Marty
• Samantha Marveggio, MHPP
• Julie Renee Marvin, OCCUPATIONAL THERAPY
• Shawn D Marvin, M.D.
• Scott Mashburn

• Physical Medicine & Rehabilitation Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Physical Medicine & Rehabilitation Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.