Active NPI
Patrick David Antoon, MD
- Family Medicine Physician
- Stamps, AR
National Provider Identifier
1891090262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R-3556
- Practice address
- 218 Church St
Stamps, AR 71860-2816 - Phone
- (870) 533-1300
- Fax
- (870) 533-1300
- NPI assigned
- Jan 17, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R-3556 | AR | Primary |
Addresses
Primary practice location
218 Church St
Stamps, AR 71860-2816
Mailing address
218 Church St
Stamps, AR 71860-2816
Phone (870) 533-1300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-3556 | AR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Health Therapy and Rehabiliation LLC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FFHDDD/Endpoint/FFHDDD
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.
-
- Physical Therapist
- Magnolia, AR
- NPI 1508892100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295222400000",
"number": "1891090262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "218 CHURCH ST",
"city": "STAMPS",
"state": "AR",
"postal_code": "718602816",
"telephone_number": "870-533-1300",
"fax_number": "870-533-1300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 CHURCH ST",
"city": "STAMPS",
"state": "AR",
"postal_code": "718602816",
"telephone_number": "870-533-1300",
"fax_number": "870-533-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTOON",
"first_name": "PATRICK",
"middle_name": "DAVID",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-17",
"last_updated": "2011-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "R-3556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stamps, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.