Individual provider Active NPI

Alicia Nicole Daniel, DPT

  • Physical Therapist
  • Springdale, AR
National Provider Identifier
1982385308
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5141 Issued in AR
Practice address
2070 McKenzie Rd Ste a
Springdale, AR 72762-0870
Phone
(479) 250-4014
NPI assigned
Jul 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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 5141 AR Primary

Addresses

Primary practice location

2070 McKenzie Rd Ste a
Springdale, AR 72762-0870

Mailing address

2110 Lacy Dr
Fayetteville, AR 72701-0463
Phone (479) 879-5652

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231204001796 AR Practitioner - Physical Therapist in Private Practice 8820443104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Russ Physical Therapy LLCGroup PAC ID 2466772447, 4 clinicians

Practice addresses (Care Compare)

2070 McKenzie Rd
Suite a
Springdale, AR 72762-0870
Phone (479) 250-4014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5141ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Russ Physical Therapy LLC Physical Therapist CurrentSince Sep 18, 2023 Accepting new patients
Russ Physical Therapy LLC Physical Therapist CurrentSince Sep 18, 2023 Accepting new patients

Locations

1002 Westpark Dr
Ste 6
Bentonville, AR 72712
Phone (479) 250-4014

2070 McKenzie Rd
Ste A
Springdale, AR 72762
Phone 4792504014 ext. 2

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1982385308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 LACY DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727010463",
            "telephone_number": "479-879-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 MCKENZIE RD STE A",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620870",
            "telephone_number": "479-250-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "ALICIA",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "5141",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 27, 2023; 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.