Individual provider Active NPI

Michael Adolph Oltmann, MD

  • Internal Medicine Physician
  • Stuttgart, AR
National Provider Identifier
1871676403
Registry record updated May 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
LL28005 Issued in SC
Practice address
1609 N Medical Dr
Stuttgart, AR 72160-3274
Phone
(870) 673-7211
Fax
(870) 672-6823
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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 6

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

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stuttgart Medical Clinic, LTD 10 clinicians

Practice addresses (Care Compare)

1609 N Medical Dr
Stuttgart, AR 72160-3274
Phone (870) 673-7395

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Forrest City, AR, CCN 047853
  • Jefferson Homecare Home health agency, White Hall, AR, CCN 047093
  • Baptist Health Medical Center-Stuttgart Hospital, Stuttgart, AR, CCN 040072
  • Baptist Health Medical Center-Stuttgart Hospital, Stuttgart, AR, CCN 041337
  • Baptist Health Medical Center North Little Rock Hospital, North Little Rock, AR, CCN 040036
  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110328000404 AR Practitioner - Internal MedicinePractitioner - Family Practice 2567518210 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E6212ARMDFamily Medicine Physician
LL28005SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Prairie Medical Group, PLLC CurrentSince Jul 28, 2014 Accepting new patients
Stuttgart Medical Clinic, LTD Family Medicine CurrentSince Feb 18, 2011 Accepting new patients
Coastal Inpatient Physicians, LLC Internal Medicine Past Accepting new patients
Baptist Health Hospitals Past Accepting new patients

Locations

110 N New York Ave
Brinkley, AR 72021
Phone (501) 734-4405

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

1012 E 22nd St
Stuttgart, AR 72160
Phone (870) 672-0911

1609 N Medical Dr
Stuttgart, AR 72160
Phone (501) 673-7211

Interoperability endpoints

  • Direct secure messaging: moltmann5358@direct.baptist-healthar.org

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL28005 SC Primary
Family Medicine Physician 207Q00000X E6212 AR

Addresses

NPPES NPI Registry

Primary practice location

1609 N Medical Dr
Stuttgart, AR 72160-3274

Mailing address

PO Box 1901
Stuttgart, AR 72160-1901
Phone (870) 673-7211

Other identifiers 10

NPPES NPI Registry
IdentifierTypeStateIssuer
100907002MedicaidAR
201481729MedicaidAR
2010478729MedicaidAR
129735729MedicaidAR
201479729MedicaidAR
201482729MedicaidAR
129734729MedicaidAR
201477729MedicaidAR
100904105MedicaidAR
136428729MedicaidAR

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 13, 2014.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1871676403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1901",
            "city": "STUTTGART",
            "state": "AR",
            "postal_code": "721601901",
            "telephone_number": "870-673-7211",
            "fax_number": "870-672-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 N MEDICAL DR",
            "city": "STUTTGART",
            "state": "AR",
            "postal_code": "721603274",
            "telephone_number": "870-673-7211",
            "fax_number": "870-672-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLTMANN",
        "first_name": "MICHAEL",
        "middle_name": "ADOLPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL28005",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E6212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100907002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201481729",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010478729",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129735729",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201479729",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201482729",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129734729",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201477729",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100904105",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136428729",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuttgart, AR

Sources for this page

Verify at the official NPI Registry.