Individual provider Active NPI

Jeffrey Nolen, PT, DPT

  • Physical Therapist
  • Bryant, AR
National Provider Identifier
1841507043
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3279 Issued in AR
Practice address
3231 Main St
Suite 3
Bryant, AR 72022-9188
Phone
(501) 847-0500
Fax
(501) 847-0508
NPI assigned
Sep 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3279 AR Primary

Addresses

Primary practice location

3231 Main St
Suite 3
Bryant, AR 72022-9188

Mailing address

6304 Kavanaugh Blvd
Little Rock, AR 72207-4255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130610000246 AR Practitioner - Physical Therapist in Private Practice 7012156714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy InstituteGroup PAC ID 7214117001, 31 clinicians

Practice addresses (Care Compare)

1909 Hinson Loop Rd
Suite 100
Little Rock, AR 72212-3903
Phone (501) 301-4530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3279ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Institute Physical Therapist CurrentSince Jul 1, 2012 Accepting new patients

Locations

5307 Kavanaugh Blvd
Little Rock, AR 72207
Phone (501) 666-2801

1 Chenal Heights Dr
Little Rock, AR 72223
Phone (201) 301-4530

1909 Hinson Loop Rd
Ste 100
Little Rock, AR 72212
Phone (501) 563-9412

100 Commerce Dr
Maumelle, AR 72113
Phone (501) 803-9722

7507 Warden Rd
Sherwood, AR 72120

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.

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1841507043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6304 KAVANAUGH BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722074255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 MAIN ST",
            "address_2": "SUITE 3",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720229188",
            "telephone_number": "501-847-0500",
            "fax_number": "501-847-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "JEFFREY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "3279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryant, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.