South Central Medical Services PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTH CENTRAL MEDICAL SERVICES PA

Doing business as

Renaissance Health and Wellness

Practice address

5212 Village Pkwy
Suite 2
Rogers, AR 72758-8104

Phone

(479) 657-6888

Fax

(479) 434-5572

NPI assigned

Feb 21, 2013

Last updated

Mar 16, 2013By 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

Dr. Chester L. Carlson, D.O.NPI 1164544045

Title

President

Phone

(501) 551-3556

Specialties & licenses 4

Addresses

Other names 1

• Renaissance Health and Wellness Doing business as

Locations

Practitioners 1

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.

• Chester L. Carlson, D.O.

  • General Practice Physician
  • Rogers, AR
  • NPI 1164544045
  Authorized official Same address or phone

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363392000000",
    "number": "1841530318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S 21ST ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014001",
            "telephone_number": "501-551-3556",
            "fax_number": "800-861-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5212 VILLAGE PKWY",
            "address_2": "SUITE 2",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588104",
            "telephone_number": "479-657-6888",
            "fax_number": "479-434-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL MEDICAL SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-03-16",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "CHESTER",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-551-3556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": "MC-2949",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renaissance Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexandria Christine Sorenson
• Amy Elizabeth Sorg, MCD CCC-SLP
• Presley Souers, LPC
• Soul in Motion Therapy, LLC
• Souls Harbor of Rogers Inc.
• South Dixieland Road Operating LLC
• South Wind Psychological Services
• Southeastern Emergency Services PC
• Brianna R Souza
• Rachel Spahn, CRNA

• Family Medicine Physician in Rogers, AR
• Providers in Rogers, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.