NPIMap

Individual provider Active NPI

Robert F Noonan, M.D.

  • Family Medicine Physician
  • Clarksville, AR
National Provider Identifier
1902867070
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E0762 Issued in AR
Practice address
25 Professional Park Dr
Clarksville, AR 72830-4432
Phone
(479) 705-8181
Fax
(479) 705-0041
NPI assigned
Mar 29, 2006
Last updated
May 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2011

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 E0762 AR Primary

Addresses

Primary practice location

25 Professional Park Dr
Clarksville, AR 72830-4432

Mailing address

25 Professional Park Dr
Clarksville, AR 72830-4432
Phone (479) 705-8181

Other identifiers 2

IdentifierTypeStateIssuer
129815001MedicaidAR
5K019OtherARARK BLUECROSS

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
I20070310000075 AR Practitioner - Family Practice 7719080837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert Frederick Noonan Jr MD PAGroup PAC ID 5890892830, 5 clinicians

Practice addresses (Care Compare)

25 Professional Park Dr
Clarksville, AR 72830-4432
Phone (479) 705-8181

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy21
Upper gastrointestinal (GI) endoscopy for acid reflux15
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

State licenses

LicenseStateTypeSpecialty
E0762ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Frederick Noonan Jr MD PA Family Medicine CurrentSince Feb 1, 2007 Accepting new patients
Johnson Regional Medical Center Past Accepting new patients
Cotner Medical Clinic Family Medicine PastSince Feb 1, 2007 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1 Medicine Dr
Clarksville, AR 72830
Phone (479) 754-5405

1100 E Poplar St
Clarksville, AR 72830
Phone (479) 754-5393

1100 E Poplar St
Ste C
Clarksville, AR 72830
Phone (479) 754-5454

25 Professional Park Dr
Clarksville, AR 72830
Phone (479) 705-8181

25 Professional Park Dr
#M
Clarksville, AR 72830
Phone (479) 705-8181

Interoperability endpoints

  • Direct secure messaging: rnoonan@cfmc-ar.direct.office.nextgen.com
  • Direct secure messaging: robert.noonan.1@20623.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1902867070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 PROFESSIONAL PARK DR",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728304432",
            "telephone_number": "479-705-8181",
            "fax_number": "479-705-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PROFESSIONAL PARK DR",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728304432",
            "telephone_number": "479-705-8181",
            "fax_number": "479-705-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "ROBERT",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E0762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129815001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARK BLUECROSS",
            "identifier": "5K019",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, AR

Sources for this page

Verify at the official NPI Registry.