Active NPI
Northwest Arkansas Renal Dialysis Associates
- Nephrology Physician
- Siloam Springs, AR
National Provider Identifier
1598876278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- E2362
- Legal business name
- NORTHWEST ARKANSAS RENAL DIALYSIS ASSOCIATES
- Doing business as
- Regional Kidney Center Siloam Springs Dialysis Clinic
- Practice address
- 500 S Mount Olive St
Suite 107
Siloam Springs, AR 72761-3602 - Phone
- (479) 524-0104
- Fax
- (479) 524-0769
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Fred Smardo, MD
- Title
- Business Owner
- Phone
- (479) 443-6688
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | E2362 | AR | Primary |
Addresses
Primary practice location
500 S Mount Olive St
Suite 107
Siloam Springs, AR 72761-3602
Mailing address
509 E Millsap Rd
Suite111
Fayetteville, AR 72703-4067
Phone (479) 443-6688
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12549 | Other | AR | BCBS |
Other names 1
- Regional Kidney Center Siloam Springs Dialysis Clinic
National Provider Directory
National Provider Directory- Tax ID family
- Northwest Arkansas Renal Dialysis Associates
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Nephrology Physician
- Springdale, AR
- NPI 1194836874
Locations
509 E Millsap Rd
Ste 111
Fayetteville, AR 72703
Phone (479) 443-6688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205884800000",
"number": "1598876278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 E MILLSAP RD",
"address_2": "SUITE111",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034067",
"telephone_number": "479-443-6688",
"fax_number": "479-527-9917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S MOUNT OLIVE ST",
"address_2": "SUITE 107",
"city": "SILOAM SPRINGS",
"state": "AR",
"postal_code": "727613602",
"telephone_number": "479-524-0104",
"fax_number": "479-524-0769"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHWEST ARKANSAS RENAL DIALYSIS ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-31",
"last_updated": "2008-03-19",
"status": "A",
"authorized_official_last_name": "SMARDO",
"authorized_official_first_name": "FRED",
"authorized_official_title_or_position": "BUSINESS OWNER",
"authorized_official_telephone_number": "479-443-6688",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": "AR",
"license": "E2362",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "12549",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Regional Kidney Center Siloam Springs Dialysis Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Siloam Springs, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.