Organization Active NPI

Radiology Consultants of Northwest Arkansas

  • Diagnostic Radiology Physician
  • Russellville, AR
National Provider Identifier
1992917728
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY CONSULTANTS OF NORTHWEST ARKANSAS
Practice address
3205 W Main St
Russellville, AR 72801-2301
Phone
(479) 968-8279
Fax
(479) 968-4331
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kerri Couch
Title
Manager
Phone
(479) 968-8279

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3205 W Main St
Russellville, AR 72801-2301

Mailing address

P.O. Box 9178
Russellville, AR 72801
Phone (479) 968-8279

Other identifiers 1

IdentifierTypeStateIssuer
57672OtherARBCBS OR ARKANSAS

National Provider Directory

National Provider Directory

Locations

34 W Colt Square Dr
Ste 1
Fayetteville, AR 72703
Phone (479) 200-0965

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992917728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-968-8279",
            "fax_number": "479-968-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012301",
            "telephone_number": "479-968-8279",
            "fax_number": "479-968-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY CONSULTANTS OF NORTHWEST ARKANSAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COUCH",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-968-8279"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OR ARKANSAS",
            "identifier": "57672",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.