Organization Active NPI

North Central Arkansas Medical Associates

  • Family Medicine Physician
  • Mountain Home, AR
National Provider Identifier
1952345183
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTH CENTRAL ARKANSAS MEDICAL ASSOCIATES
Practice address
614 North Town
Mountain Home, AR 72653-3105
Phone
(870) 425-3131
Fax
(870) 425-3136
NPI assigned
Jun 16, 2006
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Kenderia Perry
Title
Project Manager
Phone
(501) 213-7313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

614 North Town
Mountain Home, AR 72653-3105

Mailing address

614 North Town
Mountain Home, AR 72653-3105
Phone (870) 425-3131

Other identifiers 1

IdentifierTypeStateIssuer
125193002MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070326000544 AR Part B Supplier - Clinic/Group Practice 0749384048 Receives reassigned benefits from 10 practitioners
Practice locations: Mountain Home, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D0676243North Central Arkansas Medical Assocs614 North Town, Mountain Home, AR 72653AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Locations

614 N Town
Mountain Home, AR 72653
Phone (870) 425-3131

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.532

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1952345183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 NORTH TOWN",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533105",
            "telephone_number": "870-425-3131",
            "fax_number": "870-424-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 NORTH TOWN",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533105",
            "telephone_number": "870-425-3131",
            "fax_number": "870-425-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CENTRAL ARKANSAS MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "KENDERIA",
        "authorized_official_title_or_position": "PROJECT MANAGER",
        "authorized_official_telephone_number": "501-213-7313"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125193002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.