NPIMap

Organization Active NPI

Saline Physician Services, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Benton, AR
National Provider Identifier
1538410147
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
SALINE PHYSICIAN SERVICES, LLC
Practice address
5 Medical Park Dr
Suite 305
Benton, AR 72015-3729
Phone
(501) 574-7400
Fax
(501) 574-7401
NPI assigned
Sep 21, 2012
Organization subpart
Yes
Parent organization
SALINE COUNTY MEDICAL SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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

Authorized official

Name
Kimberly Titsworth
Title
Director, Physician Services
Phone
(501) 776-6093

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

5 Medical Park Dr
Suite 305
Benton, AR 72015-3729

Mailing address

PO Box 2577
Benton, AR 72018-2577
Phone (501) 776-6252

Other names 1

  • Healthy Aging Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348185600000",
    "number": "1538410147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2577",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720182577",
            "telephone_number": "501-776-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PARK DR",
            "address_2": "SUITE 305",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153729",
            "telephone_number": "501-574-7400",
            "fax_number": "501-574-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALINE PHYSICIAN SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SALINE COUNTY MEDICAL SYSTEM",
        "enumeration_date": "2012-09-21",
        "last_updated": "2012-09-21",
        "status": "A",
        "authorized_official_last_name": "TITSWORTH",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR, PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "501-776-6093"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Aging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.