NPIMap

Individual provider Active NPI

Philip Dunn Elangwe, M.D.

  • Family Medicine Physician
  • Fort Smith, AR
National Provider Identifier
1780776435
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E5047 Issued in AR
Practice address
2420 Rogers Ave
Fort Smith, AR 72901-4164
Phone
(479) 782-0244
Fax
(479) 782-0267
NPI assigned
Sep 29, 2006
Last updated
Aug 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X E5047 AR Primary

Addresses

Primary practice location

2420 Rogers Ave
Fort Smith, AR 72901-4164

Mailing address

2420 Rogers Ave
Fort Smith, AR 72901-4164
Phone (479) 782-0244

Other identifiers 2

IdentifierTypeStateIssuer
172829001MedicaidAR
200169740AMedicaidOK

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
I20080708000056 AR Practitioner - Family Practice 6608948732 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elangwe Enterprises IncGroup PAC ID 3476677444, 3 clinicians

Practice addresses (Care Compare)

2420 Rogers Ave
Fort Smith, AR 72901-4164
Phone (479) 782-0244

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.39 of 100Reported as individual
Quality
20
Improvement activities
40
Cost
77.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E5047ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Arkansas Counseling & Guidance Center, Inc Current Accepting new patients
Elangwe Enterprises Inc Family Medicine CurrentSince Aug 1, 2010 Accepting new patients
The Guidance Center - Whole Health Family Medicine CurrentSince Apr 1, 2021 Accepting new patients
The Guidance Center - Paris Clinic CurrentSince Apr 1, 2021 Accepting new patients
Main Street Operating LLC PastSince Apr 1, 2023 Accepting new patients
Sgoh Acquisition Inc Past Accepting new patients
Fort Smith Hma, LLC Past Accepting new patients
Baptist Health Regional Hospitals Past Accepting new patients
Sparks Regional Medical Center Past Accepting new patients

Locations

2420 Rogers Ave
Fort Smith, AR 72901
Phone (479) 782-0244

3117 S 70th St
Fort Smith, AR 72903
Phone 4797859400 ext. 1604

5301 Wheeler Ave
Fort Smith, AR 72901
Phone (476) 646-3454

1857 Rice St
Waldron, AR 72958
Phone (479) 637-2468

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Blossoms at Van Buren Rehab & Nursing CenterVan Buren, AR, CCN 045326 Skilled nursing facility Adp of the SNF Apr 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1780776435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014164",
            "telephone_number": "479-782-0244",
            "fax_number": "479-709-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014164",
            "telephone_number": "479-782-0244",
            "fax_number": "479-782-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELANGWE",
        "first_name": "PHILIP",
        "middle_name": "DUNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2021-08-05",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E5047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172829001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200169740A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.