Organization Active NPI

Plastic Surgery and Hand Center of Nwa, PLC

  • Plastic Surgery Physician
  • Rogers, AR
National Provider Identifier
1568666444
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
E3659 Issued in AR
Legal business name
PLASTIC SURGERY AND HAND CENTER OF NWA, PLC
Practice address
3333 Pinnacle Hills Parkway
Suite 300
Rogers, AR 72758-9000
Phone
(479) 464-9191
Fax
(479) 464-8840
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Authorized official

Name
Mark A Kendall, M.D.
Title
Owner
Phone
(479) 464-9191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X E3659 AR Primary

Addresses

Primary practice location

3333 Pinnacle Hills Parkway
Suite 300
Rogers, AR 72758-9000

Mailing address

3333 Pinnacle Hills Parkway
Suite 300
Rogers, AR 72758-9000
Phone (479) 464-9191

Other identifiers 1

IdentifierTypeStateIssuer
152013002MedicaidAR

National Provider Directory

National Provider Directory

Locations

1502 SE 28th St
Ste 4
Bentonville, AR 72712
Phone (479) 464-9191

3333 S Pinnacle Hills Pkwy
Ste 300
Rogers, AR 72758
Phone (479) 464-7171

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1568666444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 PINNACLE HILLS PARKWAY",
            "address_2": "SUITE 300",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589000",
            "telephone_number": "479-464-9191",
            "fax_number": "479-464-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 PINNACLE HILLS PARKWAY",
            "address_2": "SUITE 300",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589000",
            "telephone_number": "479-464-9191",
            "fax_number": "479-464-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY AND HAND CENTER OF NWA, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "KENDALL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-464-9191",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "AR",
            "license": "E3659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152013002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.