NPIMap

Organization Active NPI

Mountaincrest Rehab of Bella Vista, Inc.

  • Physical Therapist
  • Bella Vista, AR
National Provider Identifier
1932165982
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2113 Issued in AR
Legal business name
MOUNTAINCREST REHAB OF BELLA VISTA, INC.
Practice address
1801 Forest Hills Blvd
Ste #205
Bella Vista, AR 72715
Phone
(479) 855-9348
Fax
(479) 855-9358
NPI assigned
Apr 26, 2006
Last updated
Apr 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Authorized official

Name
Mr. Stewart T Ong, PTNPI 1588614945
Title
Owner
Phone
(479) 855-9348

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Physical Therapist 225100000X PT1741 AR
Physical Therapist 225100000X PT2105 AR
Physical Therapist 225100000X PT2113 AR Primary

Addresses

Primary practice location

1801 Forest Hills Blvd
Ste #205
Bella Vista, AR 72715

Mailing address

1801 Forest Hills Blvd.
Ste #205
Bella Vista, AR 72715
Phone (479) 855-9348

Other identifiers 3

IdentifierTypeStateIssuer
157687742MedicaidAR
143683721MedicaidAR
5F289OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050422000677 AR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2365480985 Receives reassigned benefits from 7 practitioners
Practice locations: Bella Vista, AR; Rogers, AR

National Provider Directory

National Provider Directory
Tax ID family
Mountaincrest Rehab of Bella Vista Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1801 Forest Hills Blvd
Ste 205
Bella Vista, AR 72715
Phone (479) 855-9348

5208 W Village Pkwy
Ste 7
Rogers, AR 72758
Phone (479) 395-6060

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1932165982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 FOREST HILLS BLVD.",
            "address_2": "STE #205",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "72715",
            "telephone_number": "479-855-9348",
            "fax_number": "479-855-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FOREST HILLS BLVD",
            "address_2": "STE #205",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "72715",
            "telephone_number": "479-855-9348",
            "fax_number": "479-855-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINCREST REHAB OF BELLA VISTA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "ONG",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-855-9348",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT1741",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT2105",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT2113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157687742",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143683721",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5F289",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bella Vista, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.