Kolton Crawford, PT
Individual provider Active NPI Physical Therapist · Cabot, AR
NPI 1962017871 · NPPES record last updated Sep 9, 2020
Key facts
- NPI
- 1962017871
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 4875 (AR)
- Practice address
- 2039 W Main St Ste B
Cabot, AR 72023-7479 - Phone
- (501) 605-8888
- NPI assigned
- Sep 9, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Orthopedic Rehabilitation Centers LLC
Premiere Physical Therapy and Sports Rehab LLC
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201015000326 | AR | Practitioner - Physical Therapist in Private Practice | 0143640078 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4875 | AR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premiere Physical Therapy and Sports Rehab LLC | Physical Therapist | Current |
Accepting new patients |
| Orthopedic Rehabilitation Centers LLC | Physical Therapist | Current |
Accepting new patients |
Locations
1600 SE J St
#4
Bentonville, AR 72712
Phone (479) 273-9933
2039 W Main St
Ste B
Cabot, AR 72023
Phone (501) 605-8888
2039 W Main St
Cabot, AR 72023
Phone (501) 758-5133
13100 Chenal Pkwy
Little Rock, AR 72211
Phone (501) 975-1915
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4875 | AR | Yes |
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
Other providers in Cabot, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.