NPIMap

Organization Active NPI

Stinnett & Scarbrough P.a,

Doing business as Holly Street Physical Therapy

  • Physical Therapist
  • Siloam Springs, AR
National Provider Identifier
1528016102
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
STINNETT & SCARBROUGH P.A,
Doing business as
Holly Street Physical Therapy
Practice address
1675 W. Jefferson
Suite a
Siloam Springs, AR 72761-1379
Phone
(479) 524-8028
Fax
(479) 524-6151
NPI assigned
May 5, 2006
Last updated
Aug 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Authorized official

Name
Mrs. Donna M Woodard
Title
Office Manager
Phone
(479) 524-8028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1675 W. Jefferson
Suite a
Siloam Springs, AR 72761-1379

Mailing address

PO Box 1379
Siloam Springs, AR 72761-1379
Phone (479) 524-8028

Other identifiers 1

IdentifierTypeStateIssuer
128034742MedicaidAR

Other names 1

  • Holly Street Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000914 AR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9638073125 Receives reassigned benefits from 5 practitioners
Practice locations: Siloam Springs, AR

National Provider Directory

National Provider Directory

Locations

1675 W Jefferson St
Ste A
Siloam Springs, AR 72761
Phone (479) 524-8028

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1528016102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1379",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727611379",
            "telephone_number": "479-524-8028",
            "fax_number": "479-524-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 W. JEFFERSON",
            "address_2": "SUITE A",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727611379",
            "telephone_number": "479-524-8028",
            "fax_number": "479-524-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STINNETT & SCARBROUGH P.A,",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-524-8028",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128034742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holly Street Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Siloam Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.