Individual provider Active NPI

James Robert Parks, M.D.

  • Psychiatry Physician
  • Fayetteville, AR
National Provider Identifier
1942496005
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
902967383 Issued in AR
Practice address
102 E Sunbridge Dr
Suite 1
Fayetteville, AR 72703-2830
Phone
(479) 790-4889
Fax
(479) 935-3159
NPI assigned
Sep 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 902967383 AR Primary

Addresses

Primary practice location

102 E Sunbridge Dr
Suite 1
Fayetteville, AR 72703-2830

Mailing address

102 E Sunbridge Dr
Suite 1
Fayetteville, AR 72703-2830
Phone (479) 790-4889

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
I20081103000760 AR Practitioner - Psychiatry 5294894432 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
902967383ARMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texarkana Behavioral Associates, L.C. Current Accepting new patients
Washington Regional Medical System CurrentSince Apr 10, 2015 Accepting new patients
Texarkana Behavioral Associates, L.C. CurrentSince Mar 4, 2020 Accepting new patients
Washington Regional Medical System Current Accepting new patients
Texarkana Behavioral Associates, L.C. CurrentSince Mar 4, 2020 Accepting new patients
Washington Regional Medical System CurrentSince Apr 10, 2015 Accepting new patients
Piney Ridge Treatment Center, LLC Past Accepting new patients
Gateway Recovery Center Past Accepting new patients

Locations

815 Fort St
Ste A
Barling, AR 72923
Phone (479) 494-5740

4253 N Crossover Rd
Fayetteville, AR 72703
Phone (479) 443-6496

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

3215 N Northhills Blvd
Ste B
Fayetteville, AR 72703
Phone (479) 463-1000

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1942496005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E SUNBRIDGE DR",
            "address_2": "SUITE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032830",
            "telephone_number": "479-790-4889",
            "fax_number": "479-935-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E SUNBRIDGE DR",
            "address_2": "SUITE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032830",
            "telephone_number": "479-790-4889",
            "fax_number": "479-935-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "902967383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.