Organization Active NPI

Favorite Family Chiropractic

  • Chiropractor
  • Springdale, AR
National Provider Identifier
1952754251
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1676 Issued in AR
Legal business name
FAVORITE FAMILY CHIROPRACTIC
Practice address
1127 S Gutensohn Rd
Suite 110
Springdale, AR 72762-5228
Phone
(479) 756-1155
Fax
(479) 756-1130
NPI assigned
Jul 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Authorized official

Name
Dr. Justin Gregory Favorite, D.C.NPI 1720092364
Title
Chiropractor
Phone
(479) 756-1155

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1676 AR Primary

Addresses

Primary practice location

1127 S Gutensohn Rd
Suite 110
Springdale, AR 72762-5228

Mailing address

1127 S Gutensohn Rd
Suite 110
Springdale, AR 72762-5228
Phone (479) 756-1155

Other identifiers 1

IdentifierTypeStateIssuer
5A018OtherARPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161207001162 AR Part B Supplier - Clinic/Group Practice 2860772969 Receives reassigned benefits from 2 practitioners
Practice locations: Springdale, AR

National Provider Directory

National Provider Directory

Locations

1127 S Gutensohn Rd
Ste 110
Springdale, AR 72762
Phone (479) 756-1155

693 White Rd
Ste E
Springdale, AR 72762
Phone (479) 756-1155

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469059200000",
    "number": "1952754251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 S GUTENSOHN RD",
            "address_2": "SUITE 110",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727625228",
            "telephone_number": "479-756-1155",
            "fax_number": "479-756-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 S GUTENSOHN RD",
            "address_2": "SUITE 110",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727625228",
            "telephone_number": "479-756-1155",
            "fax_number": "479-756-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAVORITE FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A",
        "authorized_official_last_name": "FAVORITE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "479-756-1155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "5A018",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.