Individual provider Active NPI

Alecia Trentham

  • Case Manager/Care Coordinator
  • Fayetteville, AR
National Provider Identifier
1619247897
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
3715 N Business Dr Ste 104
Fayetteville, AR 72703-5287
Phone
(479) 521-1532
Fax
(479) 521-9940
NPI assigned
Jan 5, 2012
Last updated
Aug 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X AR Primary

Addresses

Primary practice location

3715 N Business Dr Ste 104
Fayetteville, AR 72703-5287

Mailing address

2153 E Joyce Blvd Ste 201
Fayetteville, AR 72703-5285
Phone (479) 575-9471

Other practice location 1

522 Mill Rd
Clarksville, AR 72830-8511
Phone (479) 705-1301

Other names 1

  • Alecia Bradshaw Other name

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

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1619247897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2153 E JOYCE BLVD STE 201",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035285",
            "telephone_number": "479-575-9471",
            "fax_number": "479-587-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 N BUSINESS DR STE 104",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035287",
            "telephone_number": "479-521-1532",
            "fax_number": "479-521-9940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "522 Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "AR",
            "postal_code": "728308511",
            "country_code": "US",
            "telephone_number": "479-705-1301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRENTHAM",
        "first_name": "ALECIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALECIA",
            "last_name": "BRADSHAW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 29, 2019; 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.