Grand Prairie Physical Therapy of Stuttgart, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT1005 Issued in AR

Legal business name

GRAND PRAIRIE PHYSICAL THERAPY OF STUTTGART, INC.

Practice address

2105 S Main St
Stuttgart, AR 72160

Phone

(870) 673-7679

Fax

(870) 673-7654

NPI assigned

Jul 13, 2006

Last updated

Jun 25, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mandy Lee Fischer

Title

Office Manager

Phone

(870) 673-7679

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Allyson Coker, PT

  • Physical Therapist
  • Stuttgart, AR
  • NPI 1164273371
  Medicare reassignment Care Compare group NPD
• Jerrie Ann Cummings, P.T.

  • Physical Therapist
  • De Witt, AR
  • NPI 1104819358
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1497770242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 S MAIN ST",
            "city": "STUTTGART",
            "state": "AR",
            "postal_code": "72160",
            "telephone_number": "870-673-7679",
            "fax_number": "870-673-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 S MAIN ST",
            "city": "STUTTGART",
            "state": "AR",
            "postal_code": "72160",
            "telephone_number": "870-673-7679",
            "fax_number": "870-673-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND PRAIRIE PHYSICAL THERAPY OF STUTTGART, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "MANDY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-673-7679",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "AR",
            "license": "PT1005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150837742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandy Erin Fuller, RD,LD
• George M Dunn Jr OD PA
• Godwin Speech Therapy
• Grand Prairie Job Center
• Grand Prairie Medical Group, PLLC
• Grand Prairie Wellness Clinic PLLC
• Paula V Greene, LPC
• Lindsay Elizabeth Guest, DC
• Gregory Todd Hammons, DO
• Brittany Hampton, MHPP

• Physical Therapy Clinic/Center in Stuttgart, AR
• Providers in Stuttgart, AR by specialty
• Physical Therapy Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.