Northwest Benton County Physician Services LLC
Organization Active NPI Family Medicine Physician · Bentonville, AR
NPI 1871553073 · NPPES record last updated May 8, 2025
Key facts
- NPI
- 1871553073
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- NORTHWEST BENTON COUNTY PHYSICIAN SERVICES LLC
- Practice address
- 1102 NW Lowes Ave Ste 2
Bentonville, AR 72712-4978 - Phone
- (479) 254-8563
- Fax
- (479) 254-8564
- NPI assigned
- Mar 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Kristina Music
- Title
- Director Provider Enrollment
- Phone
- (877) 892-9815
Practitioners 161
-
Lynda D Banwart, NP-C
-
Joshua R Block, M.D.
-
Randy Conover, D.O.
-
Angela Jo Craig, APRN
-
George Ryan Declerk, M.D.
-
Wendy Joanne Hart, DNP, AGACNP-BC, APRN
-
Navneet Kaur, M.D.
-
Anthony John Klappa, M.D.
-
Craig Steven Levoy, M.D.
-
Patricia J Mendoza, APRN
-
Kory Dee Miskin, DPM
-
Ashley Renee Moyer, APRN
-
Philip Paul Pack III, D.O.
-
John G. Price, MD
-
Pearl Anne Samuel, M.B.B.S
-
Toby Gage Saunders, APRN, FNP-BC
-
Ron D Schechter, MD
-
Patricia Ellen Sheppard, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050509000505 | AR | Part B Supplier - Clinic/Group Practice | 3577503689 |
Receives reassigned benefits from 144 practitioners Practice locations: Pea Ridge, AR; Rogers, AR; Eureka Springs, AR; Siloam Springs, AR; Springdale, AR; Bentonville, AR; Fayetteville, AR; Certerton, AR |
National Provider Directory
Locations
1801 Forest Hills Blvd
Ste 131
Bella Vista, AR 72715
2900 Medical Center Pkwy
Ste 380
Bentonville, AR 72712
Phone (479) 553-3340
2900 Medical Center Pkwy
Ste 370
Bentonville, AR 72712
Phone (479) 553-2525
1102 NW Lowes Ave
Ste 4
Bentonville, AR 72712
Phone (479) 553-2470
1502 SE 28th St
Ste 8
Bentonville, AR 72712
Phone (479) 273-1033
2900 Medical Center Pkwy
Ste 240
Bentonville, AR 72712
Phone (479) 273-3374
2618 SE J St
Bentonville, AR 72712
910 NW 7th St
Bentonville, AR 72712
Phone (479) 250-9838
2900 Medical Center Pkwy
Ste 220
Bentonville, AR 72712
Phone (479) 464-9191
331 Commercial St
Centerton, AR 72719
Phone (479) 795-2167
2875 E Joyce Blvd
Fayetteville, AR 72703
Phone (479) 966-4999
3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050
189 Townsend Way
Pea Ridge, AR 72751
Phone (479) 451-2022
2000 S 42nd St
Rogers, AR 72758
Phone (479) 254-0434
2000 S 42nd St
Ste 1000
Rogers, AR 72758
2000 S 42nd St
Ste 100
Rogers, AR 72758
Phone (479) 273-9173
1001 W Walnut St
Ste 6
Rogers, AR 72756
Phone (479) 246-0400
1615 W Persimmon St
Ste B
Rogers, AR 72756
Phone (479) 636-7192
1001 S 6th St
Rogers, AR 72756
Phone (479) 553-4540
601 W Maple Ave
Ste 704
Springdale, AR 72764
Phone (479) 521-2752
601 W Maple Ave
Ste 603
Springdale, AR 72764
Phone (479) 757-4700
4077 Elm Springs Rd
Ste 105
Springdale, AR 72762
Phone (479) 757-8099
601 W Maple Ave
Ste 213
Springdale, AR 72764
Phone (479) 750-2080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1102 NW Lowes Ave Ste 2
Bentonville, AR 72712-4978
Mailing address
PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7385
Other practice location 1
5501 Willow Creek Dr Ste 101
Springdale, AR 72762-8707
Phone (479) 757-8050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD6410 | Other | AR | RR MEDICARE |
Other providers in Bentonville, AR
- Northwest Arkansas Immunization
- Northwest Arkansas Integrated Medical, Inc
- Northwest Arkansas Internal Medicine, PLLC
- Northwest Arkansas Primary Care Physicians, PA
- Northwest Arkansas Renal Dialysis Associates
- Northwest Counseling, Inc.
- Northwest Health & Lifestyle Centre
- Alicia Norton
- Lauren Hart Norton
- Rebecca Norton
All providers in Bentonville, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.