Brent A Davis, DPT
Individual provider Active NPI Physical Therapist · Trumann, AR
NPI 1982254710 · NPPES record last updated Sep 13, 2019
Key facts
- NPI
- 1982254710
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT4650 (AR)
- Practice address
- 516 Industrial Park Access Rd
Trumann, AR 72472 - Phone
- (870) 483-6131
- Fax
- (870) 483-2573
- NPI assigned
- Sep 13, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northeast Arkansas Clinic Charitable Foundation, Inc.
Practice addresses (Care Compare)
516 Industrial Park Dr
Trumann, AR 72472-9602
Phone (870) 935-8388
Merit-based Incentive Payment System (MIPS)
- Final score
- 75.65 of 100
- Quality
- 44.87
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.98
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191024002332 | AR | Practitioner - Physical Therapist in Private Practice | 0749512796 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT4650 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Current |
Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Current |
Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Current | Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Past | Accepting new patients |
Locations
1111 Windover Rd
Jonesboro, AR 72401
Phone (870) 935-5432
909 Enterprise Dr
Jonesboro, AR 72401
Phone (870) 336-1100
516 Industrial Park Dr
Trumann, AR 72472
Phone (870) 483-6131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT4650 | AR | Yes |
Addresses
Primary practice location
516 Industrial Park Access Rd
Trumann, AR 72472
Mailing address
PO Box 1960
Jonesboro, AR 72403-1960
Phone (870) 483-6131
Other providers in Trumann, AR
- Klassi Crockett
- Lacey Lynn Crotts
- Alexia Crow
- Customeyes Vision Care of Trumann, Inc
- Ashley Davie
- Gwendolyn Davis
- Kieara Davis
- Dayspring Services of Arkansas LLC
- Daven Debow
- Delta EMS
All providers in Trumann, AR · Physical Therapist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2019. 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.