Individual provider Active NPI

Kolton Crawford, PT

  • Physical Therapist
  • Cabot, AR
National Provider Identifier
1962017871
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4875 Issued in AR
Practice address
2039 W Main St Ste B
Cabot, AR 72023-7479
Phone
(501) 605-8888
NPI assigned
Sep 9, 2020
Last updated
Sep 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4875 AR Primary

Addresses

Primary practice location

2039 W Main St Ste B
Cabot, AR 72023-7479

Mailing address

105 Dayton Dr
Judsonia, AR 72081-9708
Phone (501) 593-9942

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201015000326 AR Practitioner - Physical Therapist in Private Practice 0143640078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Orthopedic Rehabilitation Centers LLCGroup PAC ID 3678560695, 10 clinicians
Premiere Physical Therapy and Sports Rehab LLCGroup PAC ID 9234236183, 16 clinicians

Practice addresses (Care Compare)

13100 Chenal Pkwy
Little Rock, AR 72211-5214
Phone (501) 975-4040

1600 SE J St
Suite 4
Bentonville, AR 72712-6804
Phone (479) 273-9933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4875ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premiere Physical Therapy and Sports Rehab LLC Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients
Orthopedic Rehabilitation Centers LLC Physical Therapist CurrentSince Sep 1, 2020 Accepting new patients

Locations

1600 SE J St
#4
Bentonville, AR 72712
Phone (479) 273-9933

2039 W Main St
Cabot, AR 72023
Phone (501) 758-5133

2039 W Main St
Ste B
Cabot, AR 72023
Phone (501) 605-8888

13100 Chenal Pkwy
Little Rock, AR 72211
Phone (501) 975-1915

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1962017871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 DAYTON DR",
            "city": "JUDSONIA",
            "state": "AR",
            "postal_code": "720819708",
            "telephone_number": "501-593-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 W MAIN ST STE B",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720237479",
            "telephone_number": "501-605-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "KOLTON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "4875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabot, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.