Individual provider Active NPI

John Charles Antuna, D.O.

  • Family Medicine Physician
  • Rogers, AR
National Provider Identifier
1508087115
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E5040 Issued in AR
Practice address
2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone
(479) 338-8000
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E5040 AR Primary
Emergency Medicine Physician 207P00000X E5040 AR

Addresses

Primary practice location

2710 S Rife Medical LN
Rogers, AR 72758-1452

Mailing address

6643 Tall Oaks Loop North
Springdale, AR 72762
Phone (479) 422-6097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070809000595 AR Practitioner - Osteopathic Manipulative MedicinePractitioner - Family PracticePractitioner - Emergency Medicine 6204927999 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
E5040ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Berryville CurrentSince Dec 16, 2024 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Dec 16, 2024 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Dec 16, 2024 Accepting new patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Bentonville Radiology Consultants, PLLC Past Accepting new patients
Arkansas Gatewood Emergency Room Services, PA Emergency Medicine Past Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

207 Carter St
Berryville, AR 72616
Phone (870) 423-6661

214 Carter St
Berryville, AR 72616
Phone (870) 423-3355

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1508087115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6643 TALL OAKS LOOP NORTH",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "72762",
            "telephone_number": "479-422-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 S RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTUNA",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E5040",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E5040",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.