Individual provider Active NPI

Justin Gregory Favorite, D.C.

  • Chiropractor
  • Springdale, AR
National Provider Identifier
1720092364
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1676 Issued in AR
Practice address
1127 S Gutensohn Rd
Ste. 110
Springdale, AR 72762-5228
Phone
(479) 756-1155
Fax
(479) 756-1130
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1676 AR Primary

Addresses

Primary practice location

1127 S Gutensohn Rd
Ste. 110
Springdale, AR 72762-5228

Mailing address

693 White Rd Ste E
Springdale, AR 72762-2918
Phone (479) 756-1155

Other identifiers 2

IdentifierTypeStateIssuer
1676OtherARSTATE LISCENSE
47-5357469OtherARTAX ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061122000424 AR Practitioner - Chiropractic 7214935402 Reassigns benefits to 1 organization
Practice locations: Springdale, AR

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Favorite Family ChiropracticGroup PAC ID 2860772969, 2 clinicians

Practice addresses (Care Compare)

693 White Rd
Suite E
Springdale, AR 72762-2918
Phone (479) 756-1155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Favorite Family Chiropractic Chiropractor CurrentSince Jan 1, 2016 Accepting new patients

Locations

1127 S Gutensohn Rd
Ste 110
Springdale, AR 72762
Phone (479) 756-1155

693 White Rd
Ste E
Springdale, AR 72762
Phone (479) 756-1155

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1720092364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "693 WHITE RD STE E",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727622918",
            "telephone_number": "479-756-1155",
            "fax_number": "479-756-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 S GUTENSOHN RD",
            "address_2": "STE. 110",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727625228",
            "telephone_number": "479-756-1155",
            "fax_number": "479-756-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVORITE",
        "first_name": "JUSTIN",
        "middle_name": "GREGORY",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISCENSE",
            "identifier": "1676",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "47-5357469",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.