Organization Active NPI

LG Sasser III MD LLC

  • Family Medicine Physician
  • Barling, AR
National Provider Identifier
1578043394
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LG SASSER III MD LLC
Practice address
1200 Fort St
Barling, AR 72923-2013
Phone
(479) 763-1511
Fax
(479) 358-1455
NPI assigned
Aug 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Authorized official

Name
Louis Gordon Sasser, MDNPI 1770581845
Title
Owner
Phone
(479) 430-8503

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X AR Primary

Addresses

Primary practice location

1200 Fort St
Barling, AR 72923-2013

Mailing address

PO Box 1446
Alma, AR 72921-1446
Phone (479) 430-8503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200319002935 AR Part B Supplier - Clinic/Group Practice 8426486705 Receives reassigned benefits from 1 practitioner
Practice locations: Springdale, AR; Van Buren, AR

National Provider Directory

National Provider Directory

Locations

3917 Rogers Ave
Fort Smith, AR 72903
Phone (479) 648-1722

623 Fayetteville Rd
Van Buren, AR 72956
Phone (479) 410-2225

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1578043394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1446",
            "city": "ALMA",
            "state": "AR",
            "postal_code": "729211446",
            "telephone_number": "479-430-8503",
            "fax_number": "479-358-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 FORT ST",
            "city": "BARLING",
            "state": "AR",
            "postal_code": "729232013",
            "telephone_number": "479-763-1511",
            "fax_number": "479-358-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LG SASSER III MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "SASSER",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-430-8503",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barling, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.