NPIMap

Individual provider Active NPI

Nathan Bennett, D.O.

  • Internal Medicine Physician
  • Ratcliff, AR
National Provider Identifier
1528088846
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C6934 Issued in AR
Practice address
9755 W State Highway 22
Ratcliff, AR 72951-9000
Phone
(479) 635-5300
Fax
(479) 635-4700
NPI assigned
Jul 20, 2006
Last updated
Apr 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C6934 AR Primary

Addresses

Primary practice location

9755 W State Highway 22
Ratcliff, AR 72951-9000

Mailing address

PO Box 130
Ratcliff, AR 72951-0130
Phone (479) 635-5300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040226001121 AR Practitioner - Internal MedicinePractitioner - Emergency Medicine 5395631139 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
R Franklin University of Med & Sci/Chicago Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians

Practice addresses (Care Compare)

1414 Hwy 71 N
Alma, AR 72921-4723
Phone (479) 632-0321

2074 Rice St
Waldron, AR 72958-7435
Phone (479) 668-4700

9755 W State Hwy 22
Ratcliff, AR 72951-9000
Phone (479) 431-2050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C6934ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Booneville CurrentSince Aug 1, 2019 Accepting new patients
River Valley Primary Care Services CurrentSince Aug 13, 2017 Accepting new patients
Mercy Hospital Ozark CurrentSince Apr 19, 2019 Accepting new patients
Mercy Hospital Paris Current Accepting new patients
Mercy Hospital Paris CurrentSince Apr 19, 2019 Accepting new patients
Mercy Hospital Paris CurrentSince Apr 19, 2019 Accepting new patients
Mercy Hospital Ozark CurrentSince Apr 19, 2019 Accepting new patients
River Valley Primary Care Services CurrentSince Aug 13, 2017 Accepting new patients
Mercy Hospital Booneville CurrentSince Aug 1, 2019 Accepting new patients
Mercy Hospital Waldron Past Accepting new patients
St. Edward Mercy Medical Center Past Accepting new patients
St Edward Medical Services, Inc. Past Accepting new patients
Mercy Medical Services, Inc Past Accepting new patients

Locations

128 Daniel Dr
Booneville, AR 72927
Phone (479) 675-2455

1273 E Highway 64
Coal Hill, AR 72832
Phone (479) 279-7670

4003 Massard Rd
Fort Smith, AR 72903
Phone (479) 226-3836

5501 Euper Ln
Fort Smith, AR 72903
Phone (479) 314-6000

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

801 W River St
Ozark, AR 72949
Phone (479) 667-4138

500 E Academy St
Paris, AR 72855
Phone (479) 963-6101

1341 W 6th St
Waldron, AR 72958
Phone (479) 637-2136

2074 Rice St
Waldron, AR 72958
Phone (479) 637-2100

Interoperability endpoints

  • Direct secure messaging: nbennett163386@directb.mercy.net
  • Direct secure messaging: nbennett589628@direct.ochin.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
River Valley Primary Care ServicesRatcliff, AR, CCN 041855 Federally qualified health center Corporate Director (5%)
W-2 Managing Employee (5%)		 Apr 1, 2019
Apr 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 16

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

View all 16

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1528088846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "RATCLIFF",
            "state": "AR",
            "postal_code": "729510130",
            "telephone_number": "479-635-5300",
            "fax_number": "479-635-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9755 W STATE HIGHWAY 22",
            "city": "RATCLIFF",
            "state": "AR",
            "postal_code": "729519000",
            "telephone_number": "479-635-5300",
            "fax_number": "479-635-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "C6934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ratcliff, AR

Sources for this page

Verify at the official NPI Registry.