Active NPI
Simranben Patel, PTA
- Physical Therapy Assistant
- Fayetteville, AR
National Provider Identifier
1558177865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2022010651
- Practice address
- 3344 N Futrall Dr
Fayetteville, AR 72703-4057 - Phone
- (479) 582-7213
- Fax
- (479) 521-1843
- NPI assigned
- Dec 10, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2022010651 | MO | Primary |
Addresses
Primary practice location
3344 N Futrall Dr
Fayetteville, AR 72703-4057
Mailing address
PO Box 1523
Fayetteville, AR 72702-1523
Phone (479) 571-6038
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022010651 | MO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1558177865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1523",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727021523",
"telephone_number": "479-571-6038",
"fax_number": "479-582-0222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3344 N FUTRALL DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034057",
"telephone_number": "479-582-7213",
"fax_number": "479-521-1843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "SIMRANBEN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-10",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2022010651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.