Organization Active NPI

Ear, Nose & Throat Associates of Mountain Home, PA

  • Otolaryngology Physician
  • Mountain Home, AR
National Provider Identifier
1790784734
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EAR, NOSE & THROAT ASSOCIATES OF MOUNTAIN HOME, PA
Practice address
626 Burnett Dr
Mountain Home, AR 72653-2941
Phone
(870) 424-4200
Fax
(870) 424-4327
NPI assigned
Jul 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Authorized official

Name
Dr. Monty Barker, M.D.
Title
President
Phone
(870) 424-4200

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X AR Primary
Pediatric Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YP0228X AR
Facial Plastic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YS0123X AR
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YX0007X AR
Otolaryngic Allergy PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YX0602X AR
Otology & Neurotology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YX0901X AR
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YX0905X AR
AudiologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 231H00000X AR

Addresses

Primary practice location

626 Burnett Dr
Mountain Home, AR 72653-2941

Mailing address

626 Burnett Dr
Mountain Home, AR 72653-2941
Phone (870) 424-4200

Other identifiers 2

IdentifierTypeStateIssuer
5B115OtherARBLUE CROSS BLUE SHIELD
CI8730OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090414000079 AR Part B Supplier - Clinic/Group Practice 9830246693 Receives reassigned benefits from 6 practitioners
Practice locations: Mountain Home, AR

National Provider Directory

National Provider Directory

Locations

520 N Pine St
Harrison, AR 72601
Phone (870) 414-4000

626 Burnett Dr
Mountain Home, AR 72653
Phone (870) 424-4200

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1790784734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 BURNETT DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532941",
            "telephone_number": "870-424-4200",
            "fax_number": "870-424-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 BURNETT DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532941",
            "telephone_number": "870-424-4200",
            "fax_number": "870-424-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE & THROAT ASSOCIATES OF MOUNTAIN HOME, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "MONTY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-424-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "AR",
            "license": null,
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "AR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5B115",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI8730",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.