NPIMap

Organization Active NPI

Physician'S Therapy Group, LLC

  • Clinic/Center
  • Fayetteville, AR
National Provider Identifier
1497783427
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
OTR 921 Issued in AR
Legal business name
PHYSICIAN'S THERAPY GROUP, LLC
Practice address
1125 N College Ave
Fayetteville, AR 72703-1908
Phone
(479) 444-7001
Fax
(479) 713-1603
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Moses Kimari, OTRNPI 1134176753
Title
Member
Phone
(501) 278-5058

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
Clinic/Center 261Q00000X OTR 921 AR Primary

Addresses

Primary practice location

1125 N College Ave
Fayetteville, AR 72703-1908

Mailing address

704 W Beebe Capps Expy
Searcy, AR 72143-6304
Phone (501) 230-9726

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497783427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 W BEEBE CAPPS EXPY",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721436304",
            "telephone_number": "501-230-9726",
            "fax_number": "501-278-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031908",
            "telephone_number": "479-444-7001",
            "fax_number": "479-713-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN'S THERAPY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIMARI",
        "authorized_official_first_name": "MOSES",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "501-278-5058",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AR",
            "license": "OTR 921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.