Pradeep Reddy Kumbham, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

E-11390 Issued in AR

Practice address

7301 Rogers Ave
Fort Smith, AR 72903-4100

Phone

(479) 314-5175

Fax

(479) 314-3185

NPI assigned

Jun 27, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

NeurologyAlso: Neuropsychiatry

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mercy Health Northwest Arkansas Communities

  • Hospitalist Physician
  • Rogers, AR
  • NPI 1699076737
  Medicare reassignment Care Compare group NPD
• Northwest Benton County Physician Services LLC

  • Family Medicine Physician
  • Bentonville, AR
  • NPI 1871553073
  Medicare reassignment NPD
• Northwest Physicians LLC

  • Obstetrics Physician
  • Springdale, AR
  • NPI 1194768721
  Medicare reassignment NPD
• Mercy Health Northwest Arkansas Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Rogers, AR
  • NPI 1770087371
  NPD
• Northwest Physicians LLC

  • Durable Medical Equipment & Medical Supplies
  • Springdale, AR
  • NPI 1205137536
  NPD
• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Rogers

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  Care Compare affiliation

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1588079560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034100",
            "telephone_number": "479-314-5175",
            "fax_number": "479-314-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034100",
            "telephone_number": "479-314-5175",
            "fax_number": "479-314-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMBHAM",
        "first_name": "PRADEEP",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AR",
            "license": "E-11390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pradeep.kumbham.1@2229.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "2900 Medical Center Pkwy Ste 310",
            "city": "Bentonville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727123214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brian L Kremer, MHPP
• Krista Boncheff Counseling and Consulting LLC
• KT Consulting PLLC
• Ashish Kumar
• Aswini Kumar, MD
• Kurt Ehlert, MD, P.a.
• Agnes V Kwo, M.D.
• Walter L Kyle, MD
• Amy E Kymer, MHPP
• Labone LLC

• Neurology Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Neurology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.