NPIMap

Organization Active NPI

Medical Associates of Northwest Arkansas PA

  • Family Medicine Physician
  • Fayetteville, AR
National Provider Identifier
1689624322
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS PA
Practice address
688 E Millsap Rd Ste 101
Fayetteville, AR 72703-3930
Phone
(479) 443-3536
Fax
(479) 443-3933
NPI assigned
May 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Terry Hurt
Title
Cfo
Phone
(479) 571-6780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

688 E Millsap Rd Ste 101
Fayetteville, AR 72703-3930

Mailing address

PO Box 1523
Fayetteville, AR 72702-1523
Phone (479) 571-6038

Other identifiers 1

IdentifierTypeStateIssuer
155661002MedicaidAR

Other names 1

  • MANA FM North Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041001000671 AR Part B Supplier - Clinic/Group Practice 3678542073 Receives reassigned benefits from 130 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bentonville, AR; Springdale, AR; Rogers, AR; Prairie Grove, AR; Lowell, AR; Harrison, AR; Fayetteville, AR; Bella Vista, AR

Other NPIs on the same Medicare enrollment 31

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 31

National Provider Directory

National Provider Directory

Locations

2523 E Huntsville Rd
Fayetteville, AR 72701
Phone (479) 442-2822

3340 N College Ave
Ste 5
Fayetteville, AR 72703
Phone (479) 443-3536

3340 N College Ave
Ste 4
Fayetteville, AR 72703
Phone (479) 443-3536

171 N Maestri Rd
#1
Tontitown, AR 72762
Phone (479) 361-1020

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1689624322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1523",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021523",
            "telephone_number": "479-571-6038",
            "fax_number": "479-582-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 E MILLSAP RD STE 101",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033930",
            "telephone_number": "479-443-3536",
            "fax_number": "479-443-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "HURT",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "479-571-6780"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155661002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MANA FM North",
            "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 Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.