Active NPI
Virgil R. Massey Jr., M.D.
- Anesthesiology Physician
- Russellville, AR
National Provider Identifier
1730180753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- C8375
- Practice address
- 1808 W Main St
Russellville, AR 72801-2724 - Phone
- (479) 968-2841
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | C8375 | AR | Primary |
Addresses
Primary practice location
1808 W Main St
Russellville, AR 72801-2724
Mailing address
PO Box 1351
Russellville, AR 72811-1351
Phone (800) 235-1415
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 770078001 | Other | AR | AR BREASTCARE |
| 5J132 | Other | AR | BLUE CROSS BLUE SHIELD AR |
| 050030511 | Other | RR MEDICARE GROUP CC5970 | |
| 123440001 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Mississippi School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1808 W Main St
St Mary'S Anesthesia
Russellville, AR 72801-2724
Phone (479) 968-3733
Hospital & facility affiliations
- St Marys Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C8375 | AR | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Mary'S Specialty LLC | Anesthesiology | Current | Accepting new patients |
Locations
1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178
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.
-
- Anesthesiology Physician
- Russellville, AR
- NPI 1831730670
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Russellville, AR
- NPI 1033160049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258588800000",
"number": "1730180753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1351",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728111351",
"telephone_number": "800-235-1415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 W MAIN ST",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728012724",
"telephone_number": "479-968-2841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSEY",
"first_name": "VIRGIL",
"middle_name": "R.",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2009-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AR",
"license": "C8375",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AR BREASTCARE",
"identifier": "770078001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD AR",
"identifier": "5J132",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP CC5970",
"identifier": "050030511",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "123440001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Russellville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.