NPIMap

Individual provider Active NPI

Jack Cameron Falck, MD

  • Emergency Medicine Physician
  • Hot Springs, AR
National Provider Identifier
1700812625
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD26470 Issued in OR
Practice address
300 Werner St
Hot Springs, AR 71913
Phone
(501) 622-1042
Fax
(501) 622-1199
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD26470 OR Primary

Addresses

Primary practice location

300 Werner St
Hot Springs, AR 71913

Mailing address

P O Box 29001
Hot Springs, AR 71903-9001
Phone (501) 622-1043

Other identifiers 2

IdentifierTypeStateIssuer
247350MedicaidOR
8508871MedicaidOR

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
I20060126000891 AR Practitioner - Emergency Medicine 9436172681 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shiloh Emergency Group PLLCGroup PAC ID 6901228154, 59 clinicians

Practice addresses (Care Compare)

300 Werner St
Hot Springs, AR 71913-6406
Phone (501) 622-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD26470ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHI St Vincent Hospital Hot Springs Emergency Medicine CurrentSince May 1, 2009 Accepting new patients
CHI St Vincent Hospital Hot Springs CurrentSince May 1, 2009 Accepting new patients
Shiloh Emergency Group PLLC Emergency Medicine CurrentSince Jun 21, 2020 Accepting new patients
McGehee Desha County Hospital Past Accepting new patients

Locations

300 Werner St
Hot Springs National Park, AR 71913
Phone (501) 622-1000

2215 Wildwood Ave
Sherwood, AR 72120
Phone (501) 522-7100

Organizations & group practices 5

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.

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1700812625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 29001",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719039001",
            "telephone_number": "501-622-1043",
            "fax_number": "501-622-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WERNER ST",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "71913",
            "telephone_number": "501-622-1042",
            "fax_number": "501-622-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCK",
        "first_name": "JACK",
        "middle_name": "CAMERON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD26470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "247350",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8508871",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

Verify at the official NPI Registry.