| Medical Associates Of Northwest Arkansas, Pa | |
|
3344 N Futrall Dr Fayetteville AR 72703-4057 | |
| (479) 521-8200 | |
| (479) 582-7310 |
| Full Name | Medical Associates Of Northwest Arkansas, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 3344 N Futrall Dr, Fayetteville, Arkansas |
| Authorized Official Name and Position | Terry Hurt (CFO) |
| Authorized Official Contact | 4795716750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Associates Of Northwest Arkansas, Pa Po Box 1523 Fayetteville AR 72702-1523 Ph: (479) 521-8200 | Medical Associates Of Northwest Arkansas, Pa 3344 N Futrall Dr Fayetteville AR 72703-4057 Ph: (479) 521-8200 |
| NPI Number | 1801847827 |
|---|---|
| Provider Enumeration Date | 05/15/2006 |
| Last Update Date | 01/17/2024 |
| Medicare PECOS PAC ID | 3678542073 |
|---|---|
| Medicare Enrollment ID | O20041001000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801847827 | NPI | - | NPPES |
| 100726870A | Medicaid | OK | |
| 155870002 | Medicaid | AR | |
| 56750 | Other | AR | AR BC/BS |
| Provider Name | Scott W Birch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760419550 PECOS PAC ID: 4688572969 Enrollment ID: I20031223000545 |
| Provider Name | Eric W Walker |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1386615979 PECOS PAC ID: 7012810161 Enrollment ID: I20040129000757 |
| Provider Name | Steven W Whitelaw |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245201813 PECOS PAC ID: 3870496524 Enrollment ID: I20040129000848 |
| Provider Name | Martin A Hannon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124029624 PECOS PAC ID: 4789668906 Enrollment ID: I20040615001748 |
| Provider Name | Josephine H Park |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811977416 PECOS PAC ID: 1951386283 Enrollment ID: I20040622000047 |
| Provider Name | Samuel J Paglianite |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235192493 PECOS PAC ID: 7810965522 Enrollment ID: I20040921000506 |
| Provider Name | James W Norys |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568407666 PECOS PAC ID: 3072582378 Enrollment ID: I20050707000192 |
| Provider Name | Todd W Logsdon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770559593 PECOS PAC ID: 4284675729 Enrollment ID: I20050810001201 |
| Provider Name | Kent J Covert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568414415 PECOS PAC ID: 0941235287 Enrollment ID: I20051005000662 |
| Provider Name | James Stewart Salmon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235175225 PECOS PAC ID: 8921077256 Enrollment ID: I20051026001179 |
| Provider Name | David W Clay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093741910 PECOS PAC ID: 8628047925 Enrollment ID: I20051027000915 |
| Provider Name | Alfred Y Gordon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063440899 PECOS PAC ID: 7618936121 Enrollment ID: I20051102000330 |
| Provider Name | Michael A Eckles |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1548298466 PECOS PAC ID: 2062430473 Enrollment ID: I20051103001132 |
| Provider Name | Sean M Livingston |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053355875 PECOS PAC ID: 6800814898 Enrollment ID: I20051108000884 |
| Provider Name | Ann-marie Magre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285660464 PECOS PAC ID: 4183683774 Enrollment ID: I20051121000894 |
| Provider Name | Laureen J Benafield |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023053733 PECOS PAC ID: 5395764641 Enrollment ID: I20051122000070 |
| Provider Name | Garland M Thorn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881630259 PECOS PAC ID: 1658330246 Enrollment ID: I20051122000290 |
| Provider Name | Meredith L Mahan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518908417 PECOS PAC ID: 4587683834 Enrollment ID: I20060112000828 |
| Provider Name | Stacy H Furlow |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457396160 PECOS PAC ID: 3577582824 Enrollment ID: I20060116000183 |
| Provider Name | Joshua David Rankin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154365732 PECOS PAC ID: 6002830478 Enrollment ID: I20060124000937 |
| Provider Name | Jonathan M Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740232693 PECOS PAC ID: 2567479470 Enrollment ID: I20060419000707 |
| Provider Name | Thomas W Hinton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992760706 PECOS PAC ID: 3577508365 Enrollment ID: I20060607000057 |
| Provider Name | Edward L Jackson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174506448 PECOS PAC ID: 2365454931 Enrollment ID: I20060622000312 |
| Provider Name | Brentley J Silvey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316998743 PECOS PAC ID: 8325050586 Enrollment ID: I20060707000184 |
| Provider Name | Orrin J Davis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083669329 PECOS PAC ID: 7810957917 Enrollment ID: I20060824000006 |
| Provider Name | Bruce D Deyoung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144294299 PECOS PAC ID: 9133124795 Enrollment ID: I20061003000637 |
| Provider Name | O K Hood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457399438 PECOS PAC ID: 0547164071 Enrollment ID: I20061028000048 |
| Provider Name | Christopher S Hardin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811916448 PECOS PAC ID: 6103825369 Enrollment ID: I20061222000076 |
| Provider Name | Kevin C Mcelroy |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467654970 PECOS PAC ID: 5193817914 Enrollment ID: I20070824000554 |
| Provider Name | Lance C Foster |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891740502 PECOS PAC ID: 8628168622 Enrollment ID: I20071213000871 |
| Provider Name | Brent V Witherington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427144005 PECOS PAC ID: 4082796800 Enrollment ID: I20080131000375 |
| Provider Name | Kelly J Hardin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225206436 PECOS PAC ID: 9032289731 Enrollment ID: I20080606000749 |
| Provider Name | Zachary S Guynn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528258514 PECOS PAC ID: 1850446394 Enrollment ID: I20090904000045 |
| Provider Name | Joseph R O'connell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992733422 PECOS PAC ID: 0446219950 Enrollment ID: I20091219000103 |
| Provider Name | Kyle G Hardy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1427094390 PECOS PAC ID: 2567431885 Enrollment ID: I20091219000110 |
| Provider Name | Ron D Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376572800 PECOS PAC ID: 4789724733 Enrollment ID: I20091222000742 |
| Provider Name | Gary L Templeton |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1477599389 PECOS PAC ID: 6608845904 Enrollment ID: I20100108000869 |
| Provider Name | Christian G Blankers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376589754 PECOS PAC ID: 4082755319 Enrollment ID: I20100108000873 |
| Provider Name | Julie A Wilkie |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346210671 PECOS PAC ID: 7911973383 Enrollment ID: I20100208000376 |
| Provider Name | Angela K Curry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205806536 PECOS PAC ID: 0648246017 Enrollment ID: I20100310000781 |
| Provider Name | Julia A Blanchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891018370 PECOS PAC ID: 7618008509 Enrollment ID: I20100621000465 |
| Provider Name | Kelly A Pierce |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962627976 PECOS PAC ID: 0547391419 Enrollment ID: I20100622000514 |
| Provider Name | Virginia L Thomas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033326434 PECOS PAC ID: 7810021094 Enrollment ID: I20100811000095 |
| Provider Name | Karl W Haws |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194767897 PECOS PAC ID: 0143346429 Enrollment ID: I20100923000894 |
| Provider Name | James S Swindle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225006737 PECOS PAC ID: 4789612623 Enrollment ID: I20101102000789 |
| Provider Name | John P Simmons |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326016833 PECOS PAC ID: 9436123395 Enrollment ID: I20101213000086 |
| Provider Name | Shawn P Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275762536 PECOS PAC ID: 4486838034 Enrollment ID: I20110406000687 |
| Provider Name | Daniel E Rasmussen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407000300 PECOS PAC ID: 1254500267 Enrollment ID: I20110809000350 |
| Provider Name | Andrew M Koehler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285808121 PECOS PAC ID: 5698944619 Enrollment ID: I20110809000378 |
| Provider Name | Randall D Staley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295918449 PECOS PAC ID: 5193982908 Enrollment ID: I20120207000316 |
| Provider Name | Benjamin R Lowery |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417172438 PECOS PAC ID: 4587842638 Enrollment ID: I20120515000194 |
| Provider Name | Vanessa H Branch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104903517 PECOS PAC ID: 6608056791 Enrollment ID: I20121105000100 |
| Provider Name | Britton B Lott |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235305491 PECOS PAC ID: 6002045291 Enrollment ID: I20140211000665 |
| Provider Name | Gregory Allen Henson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467715656 PECOS PAC ID: 6002048907 Enrollment ID: I20140408000810 |
| Provider Name | Mark A Moseley |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1740441005 PECOS PAC ID: 2062686553 Enrollment ID: I20140604000143 |
| Provider Name | Cody R Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588928436 PECOS PAC ID: 6800010711 Enrollment ID: I20140617000037 |
| Provider Name | Michelle N Dallas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992110860 PECOS PAC ID: 7911124714 Enrollment ID: I20140818001845 |
| Provider Name | Katherine L Spears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326445578 PECOS PAC ID: 9739404419 Enrollment ID: I20150223000455 |
| Provider Name | Bobby C Pritchett |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1386037463 PECOS PAC ID: 3375861214 Enrollment ID: I20150406001059 |
| Provider Name | Holly Suzanne Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881086148 PECOS PAC ID: 9638490253 Enrollment ID: I20150609000238 |
| Provider Name | Samuel N Cooke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114281060 PECOS PAC ID: 8224343470 Enrollment ID: I20150817001883 |
| Provider Name | Yvonne Paulette Couch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447385398 PECOS PAC ID: 9032409107 Enrollment ID: I20160601001792 |
| Provider Name | Lindsey A Barnes |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1295962348 PECOS PAC ID: 2062660210 Enrollment ID: I20160608000984 |
| Provider Name | Clinton C Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659660314 PECOS PAC ID: 7911147822 Enrollment ID: I20160722000522 |
| Provider Name | Andrea N Placzek |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639498512 PECOS PAC ID: 3678889136 Enrollment ID: I20160802003218 |
| Provider Name | Abby K Baldwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740629625 PECOS PAC ID: 0244548790 Enrollment ID: I20160809000149 |
| Provider Name | Michelle Elizabeth Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447603808 PECOS PAC ID: 9638464563 Enrollment ID: I20160817000666 |
| Provider Name | Mary N Ford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356323042 PECOS PAC ID: 4880718006 Enrollment ID: I20170308000431 |
| Provider Name | Lonna S Bufford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790952067 PECOS PAC ID: 0749505949 Enrollment ID: I20170327001448 |
| Provider Name | Song Zang |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1821203233 PECOS PAC ID: 4486702180 Enrollment ID: I20170512000611 |
| Provider Name | Katherine E Rankin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245529528 PECOS PAC ID: 1355631599 Enrollment ID: I20170523000365 |
| Provider Name | Elizabeth B Ferebee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700205614 PECOS PAC ID: 6002135712 Enrollment ID: I20170602000449 |
| Provider Name | Justin Waldorf |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114291838 PECOS PAC ID: 0446569446 Enrollment ID: I20180124001263 |
| Provider Name | Jody R Francisco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659888188 PECOS PAC ID: 0547521072 Enrollment ID: I20180226001965 |
| Provider Name | Whitney A Sipe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104183169 PECOS PAC ID: 1557590601 Enrollment ID: I20180530002227 |
| Provider Name | Patrick M Mcgowan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730569310 PECOS PAC ID: 6901109859 Enrollment ID: I20180607002291 |
| Provider Name | Holly Jo Gonzales |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184984155 PECOS PAC ID: 3870819436 Enrollment ID: I20180625003320 |
| Provider Name | Kody A Nichols |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255726097 PECOS PAC ID: 9032425376 Enrollment ID: I20180725003281 |
| Provider Name | Marie H Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972006542 PECOS PAC ID: 9234491556 Enrollment ID: I20180926003843 |
| Provider Name | David M Sence |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1306327879 PECOS PAC ID: 2860744133 Enrollment ID: I20181015002821 |
| Provider Name | Alan F Udouj |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730202417 PECOS PAC ID: 4688910839 Enrollment ID: I20190109002737 |
| Provider Name | Jamie S Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265999007 PECOS PAC ID: 4082955679 Enrollment ID: I20190409000591 |
| Provider Name | Nathan E Tobey |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1306188479 PECOS PAC ID: 5597080275 Enrollment ID: I20190524001999 |
| Provider Name | Grant M Gaines |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154784320 PECOS PAC ID: 3173815693 Enrollment ID: I20190528001891 |
| Provider Name | Andrew M Coppola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831548270 PECOS PAC ID: 5496098766 Enrollment ID: I20190530001208 |
| Provider Name | Joe Vernon Casey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104825116 PECOS PAC ID: 3173528296 Enrollment ID: I20190618001286 |
| Provider Name | Amy J Randall |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568825438 PECOS PAC ID: 5799079554 Enrollment ID: I20190710000660 |
| Provider Name | Nicholas W Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215562459 PECOS PAC ID: 8224467691 Enrollment ID: I20200406002570 |
| Provider Name | Bennett O Battle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508277161 PECOS PAC ID: 9638495120 Enrollment ID: I20200520000239 |
| Provider Name | Michael K May |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265939342 PECOS PAC ID: 1052736857 Enrollment ID: I20200810002455 |
| Provider Name | Kyle C Sierocuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235757816 PECOS PAC ID: 1658798384 Enrollment ID: I20200826003001 |
| Provider Name | Elizabeth A Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023627577 PECOS PAC ID: 8426478926 Enrollment ID: I20201022001916 |
| Provider Name | Amanda E Potter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730795246 PECOS PAC ID: 2365852266 Enrollment ID: I20201104001760 |
| Provider Name | Mary Elizabeth Nabers Lewis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699093302 PECOS PAC ID: 3971749623 Enrollment ID: I20210209000262 |
| Provider Name | Desiree R Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992396915 PECOS PAC ID: 8022423094 Enrollment ID: I20210225000885 |
| Provider Name | Jonathan R Kruger |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1093031940 PECOS PAC ID: 5496987240 Enrollment ID: I20210319001099 |
| Provider Name | Jay T Patrick |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275109431 PECOS PAC ID: 1759781628 Enrollment ID: I20210615000405 |
| Provider Name | Anamika Tandon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356720072 PECOS PAC ID: 7719282474 Enrollment ID: I20210629002701 |
| Provider Name | Elise N Rippelmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407332406 PECOS PAC ID: 3072865625 Enrollment ID: I20210910001278 |
| Provider Name | Sarah A Highfill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922777051 PECOS PAC ID: 7315335718 Enrollment ID: I20211103001534 |
| Provider Name | Claire K Skinner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275295206 PECOS PAC ID: 2567851777 Enrollment ID: I20211109002796 |
| Provider Name | Scott R Bland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285131383 PECOS PAC ID: 3375942634 Enrollment ID: I20211110000736 |
| Provider Name | Michelle C Walters |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558344127 PECOS PAC ID: 2769385863 Enrollment ID: I20220107000585 |
| Provider Name | Whitney S Alexander |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487635421 PECOS PAC ID: 5991198509 Enrollment ID: I20220203000336 |
| Provider Name | Kimberly R Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861138901 PECOS PAC ID: 8820476179 Enrollment ID: I20220527001893 |
| Provider Name | Signe L Rebolledo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205290046 PECOS PAC ID: 4688967375 Enrollment ID: I20220627000128 |
| Provider Name | Marissa I Acevedo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1679200109 PECOS PAC ID: 9234512484 Enrollment ID: I20220819002953 |
| Provider Name | Julie L Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689397952 PECOS PAC ID: 6608252291 Enrollment ID: I20221005002135 |
| Provider Name | Susan Singer Langston |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275730442 PECOS PAC ID: 0840489464 Enrollment ID: I20230207002833 |
| Provider Name | Matthew S Bradley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831728542 PECOS PAC ID: 3375965411 Enrollment ID: I20230613000798 |
| Provider Name | Lauren N Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447785787 PECOS PAC ID: 1557630175 Enrollment ID: I20230718000001 |
| Provider Name | Peyton D Baker |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1861021339 PECOS PAC ID: 2163883828 Enrollment ID: I20230728000661 |
| Provider Name | Edward W Wooten |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144217373 PECOS PAC ID: 7416027107 Enrollment ID: I20230828001606 |
| Provider Name | Haley A Phelan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861263311 PECOS PAC ID: 1658714266 Enrollment ID: I20240212001142 |
| Provider Name | Richard A Woods |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811759699 PECOS PAC ID: 3678916095 Enrollment ID: I20240213000958 |
| Provider Name | Nancy A Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265127674 PECOS PAC ID: 0446692248 Enrollment ID: I20240524001388 |
Community Clinic Fayetteville Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3162 W Martin Luther King Blvd, Suites 13 & 14, Fayetteville, AR 72704 Phone: 479-935-4834 Fax: 479-751-2878 | |
K E Management Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 E Augustine Ln Ste 7, Fayetteville, AR 72703 Phone: 479-200-9812 Fax: 866-243-7203 | |
Bryan Abernathy Md Pa Dba Abernathy Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1806 N Crossover Rd, Suite 4, Fayetteville, AR 72701 Phone: 479-521-5603 Fax: 479-521-5773 | |
Truhealth Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2630 E Citizens Dr, Suite 3, Fayetteville, AR 72703 Phone: 479-527-9966 Fax: 479-527-9677 | |
Washington County Hiv Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3270 N. Wimberly Drive, Fayetteville, AR 72703 Phone: 479-973-8450 Fax: 479-973-8452 | |
Arcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1792 E Joyce Blvd, Fayetteville, AR 72703 Phone: 501-500-5001 Fax: 501-500-5001 | |
Dr James Dunn Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4368 E Churchill Dr, Fayetteville, AR 72701 Phone: 479-442-4553 Fax: 479-251-1006 |