Individual provider Active NPI

Joe D Staggs, MD

  • Internal Medicine Physician
  • Fort Smith, AR
National Provider Identifier
1548257520
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C4532 Issued in AR
Practice address
708 Lexington Ave
Fort Smith, AR 72901-4738
Phone
(479) 782-4470
Fax
(479) 782-6131
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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 C4532 AR Primary

Addresses

Primary practice location

708 Lexington Ave
Fort Smith, AR 72901-4738

Mailing address

PO Box 402319
Atlanta, GA 30384-2319
Phone (479) 709-7399

Other identifiers 2

IdentifierTypeStateIssuer
105773001MedicaidAR
100251310CMedicaidOK

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
I20040924000521 AR Practitioner - Internal Medicine 7911975198 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sparks Regional Medical Center Past Accepting new patients
Sparks Medical Foundatin Past Accepting new patients
Fort Smith Hma, LLC Past Accepting new patients

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1548257520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402319",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842319",
            "telephone_number": "479-709-7399",
            "fax_number": "479-709-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 LEXINGTON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014738",
            "telephone_number": "479-782-4470",
            "fax_number": "479-782-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGGS",
        "first_name": "JOE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "C4532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105773001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251310C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.