NPIMap

Individual provider Active NPI

Upton Gardner Siddons Sr., MD

  • Family Medicine Physician
  • Greenwood, AR
National Provider Identifier
1871084301
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-12892 Issued in AR
Practice address
1480 W Center St
Greenwood, AR 72936-3449
Phone
(479) 996-5585
NPI assigned
May 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-12892 AR Primary

Addresses

Primary practice location

1480 W Center St
Greenwood, AR 72936-3449

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (479) 996-5585

Other practice location 1

UAMS - West
612 South 12th St
Fort Smith, AR 72901
Phone (479) 785-2431

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
I20210806001627 AR Practitioner - Family Practice 9335497361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health ServicesGroup PAC ID 0648514133, 103 clinicians

Practice addresses (Care Compare)

1301 S E St
Fort Smith, AR 72901-3892
Phone (479) 785-2431

1480 W Ctr St
Greenwood, AR 72936-3449
Phone (479) 996-5585

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jan 12, 2022 Accepting new patients
Baptist Health Services Current Accepting new patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jan 12, 2022 Accepting new patients
Baptist Health Services Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Baptist Health Regional Hospitals Past Accepting new patients

Locations

1301 S E St
Fort Smith, AR 72901
Phone (479) 785-2431

612 S 12th St
Fort Smith, AR 72901
Phone (479) 785-2431

6100 Massard Rd
Fort Smith, AR 72916
Phone (479) 441-5151

1120 Lexington Ave
Fort Smith, AR 72901
Phone (479) 709-7260

1500 Dodson Ave
Ste 285B
Fort Smith, AR 72901
Phone (479) 709-7025

1480 W Center St
Greenwood, AR 72936
Phone (479) 441-5151

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

Interoperability endpoints

  • Direct secure messaging: usiddons278756@direct.baptist-healthar.org

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1871084301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "479-996-5585",
            "fax_number": "479-996-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 W CENTER ST",
            "city": "GREENWOOD",
            "state": "AR",
            "postal_code": "729363449",
            "telephone_number": "479-996-5585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "UAMS - West",
            "address_2": "612 South 12th St",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "72901",
            "country_code": "US",
            "telephone_number": "479-785-2431",
            "fax_number": "479-785-0732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDONS",
        "first_name": "UPTON",
        "middle_name": "GARDNER",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-12892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, AR

Sources for this page

Verify at the official NPI Registry.