Individual provider Active NPI

Orin Paul Trentham III, MD

  • Internal Medicine Physician
  • Russellville, AR
National Provider Identifier
1992740260
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
106911 Issued in MO
Practice address
1808 W Main St
Russellville, AR 72801-2724
Phone
(479) 968-2841
NPI assigned
Jun 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-12463 AR
Internal Medicine Physician 207R00000X 106911 MO Primary

Addresses

Primary practice location

1808 W Main St
Russellville, AR 72801-2724

Mailing address

5515 Impala Dr
Joplin, MO 64804-8293
Phone (417) 540-1036

Other identifiers 5

IdentifierTypeStateIssuer
100165470BMedicaidKS
100181910AMedicaidOK
207744806MedicaidMO
9296OtherMOANTHEM
110111900OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071114000050 MO Practitioner - Internal Medicine 1850489568 Reassigns benefits to 2 organizations
I20200319002706 AR Practitioner - Internal Medicine 1850489568 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

1701 Club Manor Dr
Suite 2B
Maumelle, AR 72113-7401
Phone (501) 851-7402

Hospital & facility affiliations

  • Baptist Health Medical Center- Conway Hospital, Conway, AR, CCN 040154
  • CHI St. Vincent Hospital Hot Springs Hospital, Hot Springs, AR, CCN 040026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-12463ARMDInternal Medicine Physician
106911MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health CurrentSince Jan 20, 2020 Accepting new patients
Select Specialty Hospital Springfield Inc CurrentSince Feb 3, 2014 Accepting new patients
St Mary'S Physician Services LLC Internal Medicine CurrentSince Jan 22, 2022 Accepting new patients
Select Specialty Hospital Springfield Inc Current Accepting new patients
St Marys Physician Services, LLC CurrentSince Jan 22, 2022 Accepting new patients
Arkansas Health Group CurrentSince Jan 25, 2020 Accepting new patients
Southeast Missouri Hospital Physicians, LLC CurrentSince May 9, 2024 Accepting new patients
Baptist Health CurrentSince Jan 20, 2020 Accepting new patients
Arkansas Health Group Internal Medicine CurrentSince Jan 25, 2020 Accepting new patients
St Marys Physician Services, LLC Past Accepting new patients
Southeast Hospital Past Accepting new patients

Locations

9601 Interstate 630
#7
Little Rock, AR 72205
Phone (501) 202-3995

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

1701 Club Manor Dr
#2B
Maumelle, AR 72113

3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000

1701 Club Manor Dr
Ste 2B
North Little Rock, AR 72113
Phone (501) 812-7216

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

101 Skyline Dr
Russellville, AR 72801
Phone (479) 968-2345

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

1630 E Primrose St
Springfield, MO 65804
Phone (417) 885-4700

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

Interoperability endpoints

  • Direct secure messaging: otrentham387911@direct.baptist-healthar.org

Organizations & group practices 11

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1992740260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 IMPALA DR",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648048293",
            "telephone_number": "417-540-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012724",
            "telephone_number": "479-968-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENTHAM",
        "first_name": "ORIN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-12463",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "106911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100165470B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100181910A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207744806",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "9296",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110111900",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.