Nathan Bennett, D.O.
Individual provider Active NPI Internal Medicine Physician · Ratcliff, AR
NPI 1528088846 · NPPES record last updated Apr 27, 2017
Key facts
- NPI
- 1528088846
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- C6934 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 30
Hospital & facility affiliations 4
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- 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, Inc
River Valley Primary Care Services
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
- Centerwell Home Health
- Gentiva
- Mercy Hospital Waldron
- Mercy Hospital Fort Smith
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| River Valley Primary Care Services |
Federally qualified health center | Corporate Director (5%) W-2 Managing Employee (5%) |
Apr 1, 2019 Apr 1, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040226001121 | AR | Practitioner - Internal Medicine |
5395631139 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C6934 | AR | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River Valley Primary Care Services | Current |
Accepting new patients | |
| River Valley Primary Care Services | Current |
Accepting new patients | |
| Mercy Hospital Paris | Current |
Accepting new patients | |
| Mercy Hospital Paris | Current |
Accepting new patients | |
| Mercy Hospital Booneville | Current |
Accepting new patients | |
| Mercy Hospital Booneville | Current |
Accepting new patients | |
| Mercy Hospital Paris | Current | Accepting new patients | |
| Mercy Hospital Ozark | Current |
Accepting new patients | |
| Mercy Hospital Ozark | Current |
Accepting new patients | |
| St Edward Medical Services, Inc. | Past | Accepting new patients | |
| Mercy Hospital Waldron | Past | Accepting new patients | |
| St. Edward Mercy Medical Center | 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
7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600
5501 Euper Ln
Fort Smith, AR 72903
Phone (479) 314-6000
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
- nbennett163386@directb.mercy.net
- nbennett589628@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | C6934 | AR | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50443 | Other | AR | AR BCBS |
| 112435003 | Medicaid | AR |
Other providers in Ratcliff, AR
- Amber R Acord
- Colleen Jane Atchley
- Donald William Burns
- Wendy A. Gaston
- Michael L Guyer
- Lauren Ashley Hall
- John Benjamin Jacobs
All providers in Ratcliff, AR · Internal Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.