Arkadelphia Physical Therapy Center, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ARKADELPHIA PHYSICAL THERAPY CENTER, INC.

Practice address

3030 Pine St
Arkadelphia, AR 71923-5325

Phone

(870) 246-8623

Fax

(870) 246-8694

NPI assigned

Nov 9, 2005

Last updated

May 15, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Todd Wilson George, M.P.T.NPI 1982685723

Title

President

Phone

(870) 246-8623

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801877659. Details of each certification follow.

• CCN 046581 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 046581

Legal name

ARKADELPHIA PHYSICAL THERAPY CENTER

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Jan 17, 2000

Last certification

Jul 17, 2019

Ownership / control type

Proprietary

Facility address

3030 Pine
Arkadelphia, AR 71923

Locations

Practitioners 4

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.

• Todd Wilson George, M.P.T.

  • Physical Therapist
  • Arkadelphia, AR
  • NPI 1982685723
  NPD (past) Authorized official
• William Austin Keith, PTA

  • Physical Therapy Assistant
  • Arkadelphia, AR
  • NPI 1700361664
  NPD (past)
• Keasha Owens, DPT

  • Physical Therapist
  • Arkadelphia, AR
  • NPI 1346155223
  NPD (past)
• Derek Andrew Ray, DPT

  • Physical Therapist
  • Fort Defiance, AZ
  • NPI 1225510415
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242345600000",
    "number": "1801877659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 PINE ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235325",
            "telephone_number": "870-246-8623",
            "fax_number": "870-246-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 PINE ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235325",
            "telephone_number": "870-246-8623",
            "fax_number": "870-246-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKADELPHIA PHYSICAL THERAPY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2009-05-15",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-246-8623",
        "authorized_official_credential": "M.P.T."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141082742",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BCBS",
            "identifier": "5C764",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Arkadelphia Medical Clinic
• Arkadelphia Public School District
• Arkadelphia Women's Clinic
• Arkansas Counseling and Psychodiagnostics, Inc.
• Arkansas Counseling and Psychodiagnostics, Inc.
• Arkansas Dental Professionals, Mongrain, P.a (Arkadelphia Dental Care)

• Clinic/Center in Arkadelphia, AR
• Providers in Arkadelphia, AR by specialty
• Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.