Individual provider Active NPI

Bennett O Battle, MD

  • Diagnostic Radiology Physician
  • Fayetteville, AR
National Provider Identifier
1508277161
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
E-10011 Issued in AR
Practice address
55 W Sunbridge Dr
Fayetteville, AR 72703-1825
Phone
(479) 442-6266
Fax
(479) 521-3877
NPI assigned
May 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X E-10011 AR Primary

Addresses

Primary practice location

55 W Sunbridge Dr
Fayetteville, AR 72703-1825

Mailing address

PO Box 1523
Fayetteville, AR 72702-1523
Phone (479) 571-6038

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
I20200520000239 AR Practitioner - Diagnostic Radiology 9638495120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Arkansas College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Northwest Arkansas, PAGroup PAC ID 3678542073, 102 clinicians

Practice addresses (Care Compare)

55 W Sunbridge Dr
Fayetteville, AR 72703-1825
Phone (479) 521-8200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-10011ARMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Northwest Arkansas PA CurrentSince Jul 1, 2020 Accepting new patients
Medical Associates of Northwest Arkansas, PA Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Medical Associates of Northwest Arkansas PA Past Accepting new patients
Medical Associates of Northwest Arkansas PA Diagnostic Radiology Past Accepting new patients

Locations

416 Town Ctr NE
Ste 416
Bella Vista, AR 72714
Phone (866) 718-6266

801 SE Plaza Ave
Ste 5
Bentonville, AR 72712
Phone (479) 271-0073

55 W Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 442-5266

3344 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 582-7213

502 N Walnut St
Harrison, AR 72601
Phone (866) 718-6266

Interoperability endpoints

  • Direct secure messaging: bbattle49748@washingtonregional.direct-ci.com

Organizations & group practices 4

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": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1508277161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1523",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021523",
            "telephone_number": "479-571-6038",
            "fax_number": "479-582-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W SUNBRIDGE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031825",
            "telephone_number": "479-442-6266",
            "fax_number": "479-521-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATTLE",
        "first_name": "BENNETT",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-16",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E-10011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.