Active NPI
Saline Heart Group, P.a.
- Specialist
- Benton, AR
National Provider Identifier
1477510220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- SALINE HEART GROUP, P.A.
- Practice address
- 1000 Hwy 35 N
Suite 8
Benton, AR 72019-2351 - Phone
- (501) 315-4008
- Fax
- (501) 315-3411
- NPI assigned
- Apr 26, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Jamie Krticka
- Title
- Office Manager
- Phone
- (501) 315-4008
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | AR | Primary |
Addresses
Primary practice location
1000 Hwy 35 N
Suite 8
Benton, AR 72019-2351
Mailing address
1000 Hwy 35 N Ste 8
P.O. Box 2860
Benton, AR 72019-2353
Phone (501) 315-4008
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5F079 | Other | AR | MEDICARE |
| 154274002 | Medicaid | AR | |
| 5F079 | Other | AR | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040706001334 | AR | Part B Supplier - Clinic/Group Practice | 3274510318 |
Receives reassigned benefits from 3 practitioners Practice locations: Benton, AR |
National Provider Directory
National Provider DirectoryLocations
1000 Highway 35 N
Ste 8
Benton, AR 72019
Phone (501) 315-4008
5 Medical Park Dr
Ste 306
Benton, AR 72015
Phone (501) 315-4008
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Acute Care Nurse Practitioner
- Little Rock, AR
- NPI 1235394446
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1477510220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 HWY 35 N STE 8",
"address_2": "P.O. BOX 2860",
"city": "BENTON",
"state": "AR",
"postal_code": "720192353",
"telephone_number": "501-315-4008",
"fax_number": "501-315-3411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 HWY 35 N",
"address_2": "SUITE 8",
"city": "BENTON",
"state": "AR",
"postal_code": "720192351",
"telephone_number": "501-315-4008",
"fax_number": "501-315-3411"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SALINE HEART GROUP, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-26",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "KRTICKA",
"authorized_official_first_name": "JAMIE",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "501-315-4008",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "AR",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "5F079",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "154274002",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5F079",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.