Organization Active NPI

Emergency Medicine of Arkansas PLLC

  • Family Medicine Physician
  • Bentonville, AR
National Provider Identifier
1487904009
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EMERGENCY MEDICINE OF ARKANSAS PLLC
Practice address
1706 SE Walton Blvd
Suite 4
Bentonville, AR 72712-3200
Phone
(479) 464-0400
Fax
(479) 268-5688
NPI assigned
Sep 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Authorized official

Name
Warren Scott Lafferty, MDNPI 1639118391
Title
Physician/Owner
Phone
(479) 464-0400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1706 SE Walton Blvd
Suite 4
Bentonville, AR 72712-3200

Mailing address

1706 SE Walton Blvd
Suite 4
Bentonville, AR 72712-3200
Phone (479) 464-0400

Other names 1

  • Lafferty Family Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200811001971 AR Part B Supplier - Clinic/Group Practice 9335565134 Receives reassigned benefits from 1 practitioner
Practice locations: Rogers, AR

National Provider Directory

National Provider Directory

Locations

1706 SE Walton Blvd
Ste 4
Bentonville, AR 72712
Phone (479) 464-0400

3333 S Pinnacle Hills Pkwy
Rogers, AR 72758
Phone (479) 338-4600

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1487904009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 SE WALTON BLVD",
            "address_2": "SUITE 4",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123200",
            "telephone_number": "479-464-0400",
            "fax_number": "479-268-5688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 SE WALTON BLVD",
            "address_2": "SUITE 4",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123200",
            "telephone_number": "479-464-0400",
            "fax_number": "479-268-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY MEDICINE OF ARKANSAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-11",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "LAFFERTY",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "479-464-0400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lafferty Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.