NPIMap

Individual provider Active NPI

Michael Bradley McAlister, M.D.

  • Family Medicine Physician
  • Russellville, AR
National Provider Identifier
1629398276
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-7843 Issued in AR
Practice address
101 Skyline Dr
Russellville, AR 72801-3363
Phone
(479) 968-2345
Fax
(479) 890-2467
NPI assigned
Jun 6, 2010
Last updated
Oct 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-7843 AR Primary

Addresses

Primary practice location

101 Skyline Dr
Russellville, AR 72801-3363

Mailing address

101 Skyline Dr
Russellville, AR 72801-3363
Phone (479) 968-2345

Other practice location 1

125 Arkansas Blvd
Texarkana, AR 71854-1963
Phone (870) 772-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130619000064 AR Practitioner - Family PracticePractitioner - Emergency Medicine 8820237076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Arkansas College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Physician Services LLCGroup PAC ID 4981698032, 49 clinicians

Practice addresses (Care Compare)

1808 W Main St
Russellville, AR 72801-2724
Phone (479) 968-2841

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-7843ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Marys Physician Services, LLC CurrentSince Jul 1, 2018 Accepting new patients
St Mary's Physician Services LLC CurrentSince Jul 1, 2018 Accepting new patients
St Marys Physician Services, LLC Past Accepting new patients

Locations

101 Skyline Dr
Russellville, AR 72801
Phone (479) 968-2345

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

Interoperability endpoints

  • Direct secure messaging: michael.mcalister.1@2433.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1275782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1629398276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SKYLINE DR",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013363",
            "telephone_number": "479-968-2345",
            "fax_number": "479-890-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SKYLINE DR",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013363",
            "telephone_number": "479-968-2345",
            "fax_number": "479-890-2467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Arkansas Blvd",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "AR",
            "postal_code": "718541963",
            "country_code": "US",
            "telephone_number": "870-772-9355",
            "fax_number": "870-772-9360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCALISTER",
        "first_name": "MICHAEL",
        "middle_name": "BRADLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-06",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-7843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.