Individual provider Active NPI

Douglas Brent Garrison, DC

  • Chiropractor
  • Mammoth Spring, AR
National Provider Identifier
1760410484
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1368 Issued in AR
Practice address
350 Bethel Ave
Mammoth Spring, AR 72554-0157
Phone
(870) 625-3355
Fax
(870) 625-3356
NPI assigned
Jun 29, 2006
Last updated
Sep 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1368 AR Primary
Chiropractor 111N00000X 006314 MO

Addresses

Primary practice location

350 Bethel Ave
Mammoth Spring, AR 72554-0157

Mailing address

PO Box 157
Mammoth Spring, AR 72554-0157
Phone (870) 625-3355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123000726 AR Practitioner - Chiropractic 9234194879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

350 Bethel Ave
Mammoth Spring, AR 72554-8001
Phone (870) 625-3355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006314MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spring River Chiropractic Chiropractor CurrentSince Apr 15, 2007 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

350 Bethel Ave
Mammoth Spring, AR 72554
Phone (870) 625-3355

350 Main St
Ste 1
Mammoth Spring, AR 72554
Phone (870) 625-3355

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1760410484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "city": "MAMMOTH SPRING",
            "state": "AR",
            "postal_code": "725540157",
            "telephone_number": "870-625-3355",
            "fax_number": "870-625-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BETHEL AVE",
            "city": "MAMMOTH SPRING",
            "state": "AR",
            "postal_code": "725540157",
            "telephone_number": "870-625-3355",
            "fax_number": "870-625-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "DOUGLAS",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1368",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006314",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mammoth Spring, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.