Arkansas Liver and Gastroenterology PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

E-7210 Issued in AR

Legal business name

ARKANSAS LIVER AND GASTROENTEROLOGY PA

Practice address

3416 Old Greenwood Rd
Fort Smith, AR 72903-5462

Phone

(479) 242-2888

NPI assigned

May 6, 2015

Last updated

Dec 14, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Sarah Jessica-Elise Coluccino

Title

Office Manager

Phone

(479) 242-2888

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Arkansas Liver and Gastroenterology PA

  • Gastroenterology Physician
  • Fort Smith, AR
  • NPI 1588519680

  O20150618000749

  Same enrollment

Locations

Practitioners 6

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.

• Amanda Blake Davis, APRN

  • Family Nurse Practitioner
  • Fort Smith, AR
  • NPI 1790220143
  Medicare reassignment Care Compare group
• Ihab Herraka, M.D.

  • Gastroenterology Physician
  • Spring Hill, FL
  • NPI 1174610018

  AR

  Medicare reassignment Care Compare group
• Bryant Nicholas Monteith, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
  • NPI 1871934521

  AR

  Medicare reassignment Care Compare group
• George M Dunn, CRNA

  • Certified Registered Nurse Anesthetist
  • Batesville, AR
  • NPI 1932375482
  Medicare reassignment NPD
• Mohamad Imam, MD

  • Gastroenterology Physician
  • Birmingham, AL
  • NPI 1447696406

  AR

  Medicare reassignment
• Daniel Don Padgett, CRNA

  • Certified Registered Nurse Anesthetist
  • Augusta, GA
  • NPI 1023283223

  AR

  Medicare reassignment

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513209600000",
    "number": "1932586260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3416 OLD GREENWOOD RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035462",
            "telephone_number": "352-871-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 OLD GREENWOOD RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035462",
            "telephone_number": "479-242-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS LIVER AND GASTROENTEROLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2017-12-14",
        "status": "A",
        "authorized_official_last_name": "COLUCCINO",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "JESSICA-ELISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-242-2888",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AR",
            "license": "E-7210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arkansas Family Supports, Inc.
• Arkansas Heart Center, PLC
• Arkansas Liver and Gastroenterology
• Arkansas Liver and Gastroenterology (Southside Specialty pharmacy)
• Arkansas Liver and Gastroenterology PA
• Arkansas Liver and Gastroenterology, PA (Southside Specialty Pharmacy)
• Arkansas Lung Center PLLC
• Arkansas Oral & Facial Surgery Center Fort Smith PLLC
• Arkansas Oral & Facial Surgery Center Fort Smith PLLC
• Arkansas Orthodontic Specialist Inc (Whitlock Orthodontics of Fort Smith)

• Clinic/Center in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.