Individual provider Active NPI

Lisa Gay Hufford

  • Physical Therapist
  • Bentonville, AR
National Provider Identifier
1629299300
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1599 Issued in AR
Practice address
1002 Westpark Dr
Bentonville, AR 72712-4173
Phone
(479) 250-4014
NPI assigned
May 1, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8173 CO
Physical Therapist 225100000X 1599 AR Primary

Addresses

Primary practice location

1002 Westpark Dr
Bentonville, AR 72712-4173

Mailing address

2310 NW Harvard Walk
Bentonville, AR 72712-3950
Phone (479) 531-7092

Other practice location 1

2660 Vickers Drive
Colorado Springs, CO 80918
Phone (719) 598-7075 ext. 12

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180406000839 AR Practitioner - Physical Therapist in Private Practice 0345514410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Russ Physical Therapy LLCGroup PAC ID 2466772447, 4 clinicians

Practice addresses (Care Compare)

1002 Westpark Dr
Suite 6
Bentonville, AR 72712-4283
Phone (479) 250-4014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8173COMDPhysical Therapist
1599ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Russ Physical Therapy LLC Physical Therapist CurrentSince Sep 12, 2017 Accepting new patients
Russ Physical Therapy LLC Physical Therapist Current Accepting new patients

Locations

1002 Westpark Dr
Ste 6
Bentonville, AR 72712
Phone (479) 250-4014

2070 McKenzie Rd
Ste A
Springdale, AR 72762
Phone (479) 250-4014

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629299300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 NW HARVARD WALK",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123950",
            "telephone_number": "479-531-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 WESTPARK DR",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124173",
            "telephone_number": "479-250-4014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2660 Vickers Drive",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "80918",
            "country_code": "US",
            "telephone_number": "719-598-7075 x12",
            "fax_number": "719-277-7217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUFFORD",
        "first_name": "LISA",
        "middle_name": "GAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8173",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "1599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.