Fort Smith Neuroscience Center, PLLC.

Primary specialty

SpecialistTaxonomy code 174400000X

License

E6954 Issued in AR

Legal business name

FORT SMITH NEUROSCIENCE CENTER, PLLC.

Practice address

7217 Cameron Park Drive
Fort Smith, AR 72903

Phone

(479) 434-3544

Fax

(479) 434-3547

NPI assigned

Sep 9, 2013

Organization subpart

No

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

Authorized official

Name

Shawn P Moore, M.D.

Title

Owner

Phone

(479) 434-3544

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1700211885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180969",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729180969",
            "telephone_number": "479-434-3544",
            "fax_number": "479-434-3547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7217 CAMERON PARK DRIVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72903",
            "telephone_number": "479-434-3544",
            "fax_number": "479-434-3547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT SMITH NEUROSCIENCE CENTER, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-09",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-434-3544",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AR",
            "license": "E6954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Fort Smith, AR
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• Specialist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.