NPIMap

Organization Active NPI

Arkansas Renal Group PA

Doing business as Hot Springs Diagnostic Associates

  • Nephrology Physician
  • Hot Springs, AR
National Provider Identifier
1699043067
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
ARKANSAS RENAL GROUP PA
Doing business as
Hot Springs Diagnostic Associates
Practice address
115 Wrights St
Hot Springs, AR 71913-6240
Phone
(501) 624-6000
Fax
(501) 321-0710
NPI assigned
Dec 13, 2011
Last updated
Sep 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Authorized official

Name
Jerry Edgin
Title
Ceo
Phone
(501) 624-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

115 Wrights St
Hot Springs, AR 71913-6240

Mailing address

115 Wrights St
Hot Springs, AR 71913-6240
Phone (501) 624-6000

Other identifiers 1

IdentifierTypeStateIssuer
191312002MedicaidAR

Other names 1

  • Hot Springs Diagnostic Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111228000680 AR Part B Supplier - Clinic/Group Practice 8921274721 Receives reassigned benefits from 18 practitioners
Practice locations: Hot Springs, AR

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Renal Group PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

620 W Grove St
Ste 101
El Dorado, AR 71730
Phone (870) 862-0801

115 Wrights St
Hot Springs National Park, AR 71913
Phone (501) 321-9803

111 Skyline Dr
Russellville, AR 72801
Phone (479) 498-4661

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569369600000",
    "number": "1699043067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WRIGHTS ST",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136240",
            "telephone_number": "501-624-6000",
            "fax_number": "501-321-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WRIGHTS ST",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136240",
            "telephone_number": "501-624-6000",
            "fax_number": "501-321-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS RENAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2019-09-25",
        "status": "A",
        "authorized_official_last_name": "EDGIN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-624-6000"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191312002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hot Springs Diagnostic Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hot Springs Diagnostic Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.