NPIMap

Organization Active NPI

University of Arkansas for Medical Sciences

  • Psychiatry Physician
  • Fayetteville, AR
National Provider Identifier
1720217599
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Practice address
3425 N Futrall Dr Ste 103
Fayetteville, AR 72703-4820
Phone
(479) 713-8350
Fax
(479) 713-8375
NPI assigned
Jul 14, 2009
Last updated
Dec 7, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
Amanda D George
Title
Vice Chancellor-Chief Financial Off
Phone
(501) 686-5670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

3425 N Futrall Dr Ste 103
Fayetteville, AR 72703-4820

Mailing address

PO Box 251420
Little Rock, AR 72225-1420
Phone (501) 686-8000

Other names 1

  • UAMS PRI NW Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031219000706 AR Part B Supplier - Clinic/Group Practice 4082528955 Receives reassigned benefits from 2,092 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Little Rock, AR; Maumelle, AR; North Little Rock, AR; Springdale, AR; Alexander, AR; Bentonville, AR; Cabot, AR; Conway, AR…

Other NPIs on the same Medicare enrollment 22

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

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Raymond Bredfeldt MD111 organizations share this tax ID, including this one
Part of
Raymond Bredfeldt MD

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 47

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 47

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1720217599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251420",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251420",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 N FUTRALL DR STE 103",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034820",
            "telephone_number": "479-713-8350",
            "fax_number": "479-713-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES",
        "enumeration_date": "2009-07-14",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE CHANCELLOR-CHIEF FINANCIAL OFF",
        "authorized_official_telephone_number": "501-686-5670"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UAMS PRI NW",
            "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 7, 2022; 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.