Active NPI
Matthew Sullivan
- Professional Counselor
- Batesville, AR
National Provider Identifier
1629328463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P2205009
- Practice address
- 1650 White Dr
Batesville, AR 72501-9384 - Phone
- (870) 919-3381
- NPI assigned
- Sep 19, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | P2205009 | AR | Primary |
Addresses
Primary practice location
1650 White Dr
Batesville, AR 72501-9384
Mailing address
2400 S 48TH St
Springdale, AR 72762-6683
Phone (479) 750-2020
Other practice location 1
1140 W Walnut St Ste 3
Rogers, AR 72756-3597
Phone (479) 631-9996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arisa Health, Inc. | Professional | Current | Accepting new patients |
| Arisa Health, Inc. | Current | Accepting new patients | |
| Dayspring Services of Arkansas LLC | Past | Accepting new patients |
Locations
25 Gap Rd
Batesville, AR 72501
Phone (870) 793-8900
2707 Browns Ln
Jonesboro, AR 72401
Phone (870) 972-4000
3302 E Moore Ave
Ofc 5
Searcy, AR 72143
2400 S 48th St
Springdale, AR 72762
Phone (479) 725-5115
Organizations & group practices 3
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.
-
- Community/Behavioral Health Agency
- Jonesboro, AR
- NPI 1306532767
-
- Community/Behavioral Health Agency
- Rogers, AR
- NPI 1285857417
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653350400000",
"number": "1629328463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 S 48TH ST",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727626683",
"telephone_number": "479-750-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 WHITE DR",
"city": "BATESVILLE",
"state": "AR",
"postal_code": "725019384",
"telephone_number": "870-919-3381"
}
],
"practiceLocations": [
{
"address_1": "1140 W Walnut St Ste 3",
"address_purpose": "LOCATION",
"city": "Rogers",
"state": "AR",
"postal_code": "727563597",
"country_code": "US",
"telephone_number": "479-631-9996",
"fax_number": "479-631-1782",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SULLIVAN",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-19",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P2205009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Batesville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.