| Northwest Benton County Physician Services Llc | |
|
3000 Medical Center Pkwy Bentonville AR 72712-3217 | |
| (479) 553-1000 | |
| Not Available |
| Full Name | Northwest Benton County Physician Services Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3000 Medical Center Pkwy, Bentonville, Arkansas |
| Authorized Official Name and Position | Kristina Music (DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Contact | 8778929815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Benton County Physician Services Llc Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7385 | Northwest Benton County Physician Services Llc 3000 Medical Center Pkwy Bentonville AR 72712-3217 Ph: (479) 553-1000 |
| NPI Number | 1871553073 |
|---|---|
| Provider Enumeration Date | 03/23/2006 |
| Last Update Date | 09/06/2024 |
| Medicare PECOS PAC ID | 3577503689 |
|---|---|
| Medicare Enrollment ID | O20050509000505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871553073 | NPI | - | NPPES |
| 157598002 | Medicaid | AR | |
| DD6410 | Other | AR | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Donna Faye Matlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295780690 PECOS PAC ID: 6709871692 Enrollment ID: I20040419001624 |
| Provider Name | Charles Edward Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972617280 PECOS PAC ID: 1658362645 Enrollment ID: I20040519000852 |
| Provider Name | Jose A Fontanilla |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1497712640 PECOS PAC ID: 7517958499 Enrollment ID: I20040519001522 |
| Provider Name | Martin A Hannon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124029624 PECOS PAC ID: 4789668906 Enrollment ID: I20040615001748 |
| Provider Name | Mark Lee Stillwell |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1568459451 PECOS PAC ID: 4082682265 Enrollment ID: I20040924000537 |
| Provider Name | Randy D Conover |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003802828 PECOS PAC ID: 7113965708 Enrollment ID: I20050423000052 |
| Provider Name | Shenandoah Ware |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558360354 PECOS PAC ID: 2365455029 Enrollment ID: I20060724000292 |
| Provider Name | John G Price |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538152699 PECOS PAC ID: 9739186156 Enrollment ID: I20061027000275 |
| Provider Name | James B Baker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225086630 PECOS PAC ID: 7911905369 Enrollment ID: I20061117000487 |
| Provider Name | Arlene U Nepomuceno |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1598765208 PECOS PAC ID: 5395723886 Enrollment ID: I20070216000229 |
| Provider Name | Shamsul Alam |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1912953373 PECOS PAC ID: 6204807209 Enrollment ID: I20070323000159 |
| Provider Name | Melanie Kristin Sutton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770695223 PECOS PAC ID: 4284626805 Enrollment ID: I20070723000177 |
| Provider Name | Scott R Musick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386672392 PECOS PAC ID: 3072597673 Enrollment ID: I20070829000330 |
| Provider Name | Christopher L Pittman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407860539 PECOS PAC ID: 7911903414 Enrollment ID: I20081023000282 |
| Provider Name | George R Declerk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205037611 PECOS PAC ID: 1456410182 Enrollment ID: I20081110000303 |
| Provider Name | Melissa Lowrimore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811056864 PECOS PAC ID: 7517029176 Enrollment ID: I20081216000675 |
| Provider Name | Jeffrey Bearden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992768105 PECOS PAC ID: 8426105461 Enrollment ID: I20090409000179 |
| Provider Name | Scarlet Travis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497749428 PECOS PAC ID: 4981752292 Enrollment ID: I20090424000302 |
| Provider Name | Gideon S Mecum |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710106042 PECOS PAC ID: 2860543410 Enrollment ID: I20090622000698 |
| Provider Name | Amy Fry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821170481 PECOS PAC ID: 8426154766 Enrollment ID: I20090711000004 |
| Provider Name | Madhu T Kalyan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1386689644 PECOS PAC ID: 0446229843 Enrollment ID: I20090820000058 |
| Provider Name | Bhargav Thangali Varadaraju |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982859351 PECOS PAC ID: 0941355911 Enrollment ID: I20090827000642 |
| Provider Name | Garrett Brian Sanford |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639370851 PECOS PAC ID: 5395893002 Enrollment ID: I20100622000925 |
| Provider Name | Burton K Bledsoe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992742522 PECOS PAC ID: 1850348574 Enrollment ID: I20100708000309 |
| Provider Name | Julia D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306163159 PECOS PAC ID: 5294867693 Enrollment ID: I20100721000243 |
| Provider Name | Mary M Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073836466 PECOS PAC ID: 4981737863 Enrollment ID: I20100728001144 |
| Provider Name | Shannon Wipf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538107511 PECOS PAC ID: 9335272533 Enrollment ID: I20100809000022 |
| Provider Name | Robert Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922041326 PECOS PAC ID: 7214120328 Enrollment ID: I20101021000769 |
| Provider Name | Sudheer Koyagura |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528261617 PECOS PAC ID: 8820283799 Enrollment ID: I20101117000970 |
| Provider Name | Hapsy D Glover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568763514 PECOS PAC ID: 3173702479 Enrollment ID: I20110119000248 |
| Provider Name | Maria Christina M Judit |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1740294032 PECOS PAC ID: 8325236995 Enrollment ID: I20110127000689 |
| Provider Name | Nuri Ilker Akkus |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538164421 PECOS PAC ID: 9739172057 Enrollment ID: I20110131000124 |
| Provider Name | Michael North |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598806192 PECOS PAC ID: 7214061423 Enrollment ID: I20110215001168 |
| Provider Name | John David Alston |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487664892 PECOS PAC ID: 1052594116 Enrollment ID: I20110517000534 |
| Provider Name | Srinivas Vengala |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710032008 PECOS PAC ID: 7618947045 Enrollment ID: I20110628000464 |
| Provider Name | Mansoor Alam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174750962 PECOS PAC ID: 8325192354 Enrollment ID: I20110718000182 |
| Provider Name | Rachel Veach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225339385 PECOS PAC ID: 0244416758 Enrollment ID: I20111018000757 |
| Provider Name | Olujoke B Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629028667 PECOS PAC ID: 5092609032 Enrollment ID: I20111020000661 |
| Provider Name | Linda Kiatoukaysy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609028828 PECOS PAC ID: 1951574656 Enrollment ID: I20111025000276 |
| Provider Name | Leann W Metheny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598052250 PECOS PAC ID: 3870766041 Enrollment ID: I20111103000398 |
| Provider Name | Allan P Weston |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417051962 PECOS PAC ID: 9739141599 Enrollment ID: I20120117000703 |
| Provider Name | Renee Kassir |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336375674 PECOS PAC ID: 0547424095 Enrollment ID: I20120612000638 |
| Provider Name | Ryan A Hueter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194967414 PECOS PAC ID: 1557510427 Enrollment ID: I20121009000670 |
| Provider Name | Adam Baird Mccall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831400852 PECOS PAC ID: 0840472361 Enrollment ID: I20121023000320 |
| Provider Name | Larry D Coker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043456023 PECOS PAC ID: 1456548098 Enrollment ID: I20130415000200 |
| Provider Name | Wilbur Flood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841490141 PECOS PAC ID: 0840216099 Enrollment ID: I20130715000603 |
| Provider Name | Herbert A Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558657635 PECOS PAC ID: 1254572597 Enrollment ID: I20130729000538 |
| Provider Name | Matthew R. Patoka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053623066 PECOS PAC ID: 9335381813 Enrollment ID: I20130813000375 |
| Provider Name | Michelle Chua Ang Poland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952429680 PECOS PAC ID: 1355434739 Enrollment ID: I20130917000068 |
| Provider Name | Donald E Wleklinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891130555 PECOS PAC ID: 2466687074 Enrollment ID: I20131106000826 |
| Provider Name | Kara Jackson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851712871 PECOS PAC ID: 4587894266 Enrollment ID: I20140225000319 |
| Provider Name | Patrick C Schiefelbein |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184868291 PECOS PAC ID: 8123246915 Enrollment ID: I20140819002391 |
| Provider Name | Luke H Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922307784 PECOS PAC ID: 1759523244 Enrollment ID: I20141023000809 |
| Provider Name | Tiffany L Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598105033 PECOS PAC ID: 5698997831 Enrollment ID: I20141104000891 |
| Provider Name | Lynn M Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164748315 PECOS PAC ID: 4880916204 Enrollment ID: I20141212002129 |
| Provider Name | Amber C Mcghee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821494857 PECOS PAC ID: 5294059200 Enrollment ID: I20150122001963 |
| Provider Name | Johnny Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093104895 PECOS PAC ID: 0143547968 Enrollment ID: I20150316001272 |
| Provider Name | Tonya Hulvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982953097 PECOS PAC ID: 9234457342 Enrollment ID: I20150421000399 |
| Provider Name | Peggy Lynn Stanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538559026 PECOS PAC ID: 5698095339 Enrollment ID: I20150521000290 |
| Provider Name | Heron B Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932591617 PECOS PAC ID: 7517287972 Enrollment ID: I20150526002459 |
| Provider Name | Steven E Kempson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972503399 PECOS PAC ID: 3870506678 Enrollment ID: I20150528000966 |
| Provider Name | Sam L Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023405198 PECOS PAC ID: 1951614296 Enrollment ID: I20150716000309 |
| Provider Name | Charles I Jones |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295978443 PECOS PAC ID: 5193033538 Enrollment ID: I20151005000409 |
| Provider Name | Amber Dawn Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356726020 PECOS PAC ID: 1557670981 Enrollment ID: I20151026000465 |
| Provider Name | Amanda Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336535350 PECOS PAC ID: 0244540698 Enrollment ID: I20151114000017 |
| Provider Name | Rebecca Aleck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598030603 PECOS PAC ID: 0941428064 Enrollment ID: I20151116000827 |
| Provider Name | Heather D Hannah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326203720 PECOS PAC ID: 7618287996 Enrollment ID: I20151117002727 |
| Provider Name | Heather B Breen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740547702 PECOS PAC ID: 1759681372 Enrollment ID: I20151203000108 |
| Provider Name | Valerie Bedwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013394287 PECOS PAC ID: 1254633282 Enrollment ID: I20160108000163 |
| Provider Name | Sarah Guntorius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386089712 PECOS PAC ID: 0840592879 Enrollment ID: I20160108000325 |
| Provider Name | Jyothirmayi Lekkala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982951992 PECOS PAC ID: 2365686961 Enrollment ID: I20160121000828 |
| Provider Name | April Durham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629335955 PECOS PAC ID: 0042456667 Enrollment ID: I20160219002049 |
| Provider Name | Pearl Samuel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407114978 PECOS PAC ID: 9739486366 Enrollment ID: I20160328000814 |
| Provider Name | Jeffrey Allen Savage |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013139666 PECOS PAC ID: 8426355694 Enrollment ID: I20160404000326 |
| Provider Name | Dana R Beierle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619210754 PECOS PAC ID: 3870890908 Enrollment ID: I20160404002333 |
| Provider Name | Patricia E Sheppard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740649920 PECOS PAC ID: 7719286442 Enrollment ID: I20160503000087 |
| Provider Name | Andrew Hamby |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760412209 PECOS PAC ID: 5395044960 Enrollment ID: I20160503001356 |
| Provider Name | Julie Lynette Tate |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578731154 PECOS PAC ID: 7719286327 Enrollment ID: I20160504000262 |
| Provider Name | Sidharth Jogani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912210444 PECOS PAC ID: 6800180480 Enrollment ID: I20160804000285 |
| Provider Name | Chaitanya Bonda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659651552 PECOS PAC ID: 5193010064 Enrollment ID: I20160817002118 |
| Provider Name | Ashley Moyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215386065 PECOS PAC ID: 6901191550 Enrollment ID: I20160823000298 |
| Provider Name | Kory Dee Miskin |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1215376058 PECOS PAC ID: 0941441018 Enrollment ID: I20161216000033 |
| Provider Name | Logan Rochelle Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396288411 PECOS PAC ID: 9739461716 Enrollment ID: I20170127000331 |
| Provider Name | Lisa Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215333075 PECOS PAC ID: 3971887662 Enrollment ID: I20170223002479 |
| Provider Name | Marat V Grigorov |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1063613628 PECOS PAC ID: 1456656040 Enrollment ID: I20170320001806 |
| Provider Name | Kristen E Fleming |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740727478 PECOS PAC ID: 3577848183 Enrollment ID: I20170322001915 |
| Provider Name | Renetta R Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487194346 PECOS PAC ID: 5496030991 Enrollment ID: I20170324000573 |
| Provider Name | Theresa J Ashley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841677622 PECOS PAC ID: 6002102993 Enrollment ID: I20170427001529 |
| Provider Name | Katie E Beal |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558709469 PECOS PAC ID: 3375777220 Enrollment ID: I20170711000527 |
| Provider Name | Pardha Naga Pavan Kumar Devaki |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912285644 PECOS PAC ID: 1153690953 Enrollment ID: I20170711001714 |
| Provider Name | Gregory Ryan Spears |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083768618 PECOS PAC ID: 4789762907 Enrollment ID: I20170829000545 |
| Provider Name | Swetha Kadali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902210875 PECOS PAC ID: 2961776828 Enrollment ID: I20170916000245 |
| Provider Name | Tori Abernathy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982147765 PECOS PAC ID: 7618250291 Enrollment ID: I20170918002872 |
| Provider Name | Pahul P Singh |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1952615007 PECOS PAC ID: 3173898970 Enrollment ID: I20171004001936 |
| Provider Name | Mandie Leigh Renner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760630131 PECOS PAC ID: 4082916630 Enrollment ID: I20180201000867 |
| Provider Name | Brian D Melloy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457716813 PECOS PAC ID: 2769786607 Enrollment ID: I20180322002116 |
| Provider Name | Melanie Ann Davidson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114454048 PECOS PAC ID: 3072882497 Enrollment ID: I20180416000780 |
| Provider Name | Natalie Mills Krodell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225546161 PECOS PAC ID: 6507120938 Enrollment ID: I20180510000905 |
| Provider Name | Alysson Blythe Gaines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437655065 PECOS PAC ID: 4981969029 Enrollment ID: I20180521001532 |
| Provider Name | Juanita Linn Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770071573 PECOS PAC ID: 5890040158 Enrollment ID: I20180611001259 |
| Provider Name | Quoc-anh Thai |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1558328278 PECOS PAC ID: 4082659198 Enrollment ID: I20180619002568 |
| Provider Name | Pradeep Kumbham |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588079560 PECOS PAC ID: 2062728934 Enrollment ID: I20180719003064 |
| Provider Name | James Robert Feher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043704497 PECOS PAC ID: 1557612777 Enrollment ID: I20180926002561 |
| Provider Name | Angela Jo Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467935114 PECOS PAC ID: 3971854027 Enrollment ID: I20180928001349 |
| Provider Name | Emilia Wobga-pasiah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407219033 PECOS PAC ID: 2769781103 Enrollment ID: I20181207001060 |
| Provider Name | Leticia Barksdale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588059281 PECOS PAC ID: 6901114545 Enrollment ID: I20181221002205 |
| Provider Name | David Allen Storm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841767118 PECOS PAC ID: 6709123607 Enrollment ID: I20190131000821 |
| Provider Name | Yves-mary Nazaire |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750744660 PECOS PAC ID: 4082913330 Enrollment ID: I20190211000850 |
| Provider Name | Cesar Hurtado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649632886 PECOS PAC ID: 4789983321 Enrollment ID: I20190313000997 |
| Provider Name | Jessica Jean Newcomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881150563 PECOS PAC ID: 6709126196 Enrollment ID: I20190321001740 |
| Provider Name | Emmanuel Obi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447791645 PECOS PAC ID: 3678840824 Enrollment ID: I20190508000049 |
| Provider Name | Aaron Zabriskie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881035244 PECOS PAC ID: 4880814193 Enrollment ID: I20190530001899 |
| Provider Name | Joshua K Sanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780148262 PECOS PAC ID: 5799019071 Enrollment ID: I20190619002756 |
| Provider Name | Oyenike Adigun-awonaike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861058547 PECOS PAC ID: 8527393255 Enrollment ID: I20190717001418 |
| Provider Name | Abbey Breanna Shields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942853254 PECOS PAC ID: 3375871056 Enrollment ID: I20190819003009 |
| Provider Name | Jaquelyn Wilansky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720519812 PECOS PAC ID: 0840568895 Enrollment ID: I20190917003947 |
| Provider Name | Navneet Kaur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417245572 PECOS PAC ID: 5890025019 Enrollment ID: I20191001000855 |
| Provider Name | Irum Azim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295276418 PECOS PAC ID: 8729365929 Enrollment ID: I20191001003228 |
| Provider Name | Kent D Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972034759 PECOS PAC ID: 7810273117 Enrollment ID: I20191010003302 |
| Provider Name | Wendy Joanne Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588213771 PECOS PAC ID: 0042541401 Enrollment ID: I20191016001258 |
| Provider Name | Porcha Leggett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962948935 PECOS PAC ID: 8820372709 Enrollment ID: I20191021002799 |
| Provider Name | Maya A Babu |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1811208788 PECOS PAC ID: 4688847825 Enrollment ID: I20200127000372 |
| Provider Name | Janet Bilyeu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801086194 PECOS PAC ID: 1254403355 Enrollment ID: I20200402002639 |
| Provider Name | Michael E Schwartz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700847514 PECOS PAC ID: 3577620467 Enrollment ID: I20200909001483 |
| Provider Name | David Lee Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679197875 PECOS PAC ID: 7416362637 Enrollment ID: I20210222002342 |
| Provider Name | Rudhir Tandon |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1245486547 PECOS PAC ID: 6204014616 Enrollment ID: I20210305000148 |
| Provider Name | Kelly Glenn Thompson-davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467043224 PECOS PAC ID: 8123434651 Enrollment ID: I20210309000884 |
| Provider Name | Jason Bailey |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1275738486 PECOS PAC ID: 4880829597 Enrollment ID: I20210421002440 |
| Provider Name | Anamika Tandon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356720072 PECOS PAC ID: 7719282474 Enrollment ID: I20210629002701 |
| Provider Name | Brendi Lynn Gale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184292880 PECOS PAC ID: 9436553963 Enrollment ID: I20210805002819 |
| Provider Name | Anthony J Klappa |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1982998837 PECOS PAC ID: 0143445155 Enrollment ID: I20220321000178 |
| Provider Name | Craig S Levoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801232400 PECOS PAC ID: 1052624442 Enrollment ID: I20220615002954 |
| Provider Name | Joshua Block |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952600132 PECOS PAC ID: 0446475131 Enrollment ID: I20220901000521 |
| Provider Name | Thomas F Satterly |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174759203 PECOS PAC ID: 5092992032 Enrollment ID: I20221205001740 |
| Provider Name | Erika Frederking |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861185399 PECOS PAC ID: 9234598616 Enrollment ID: I20230703000897 |
| Provider Name | Toby Gage Lankford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295410272 PECOS PAC ID: 3779943626 Enrollment ID: I20230724003169 |
| Provider Name | Philip Pitts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326047341 PECOS PAC ID: 6305749128 Enrollment ID: I20231228001450 |
| Provider Name | Jordan Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922461698 PECOS PAC ID: 5890094247 Enrollment ID: I20240130002289 |
Amethyst Chiropractic, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 Mallard Pl Ste A, Bentonville, AR 72712 Phone: 404-484-2562 | |
Northwest Arkansas Internal Medicine, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2805 Mid Cities Dr, Suite 3, Bentonville, AR 72712 Phone: 479-876-8866 | |
Tucker Family Medicine Of Arkansas, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2905 S Walton Blvd, Ste. 17, Bentonville, AR 72712 Phone: 870-405-8579 | |
Benton Neurocare Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 811 Se 28th St Ste 5, Bentonville, AR 72712 Phone: 479-254-9761 Fax: 479-254-9732 | |
Taylored Therapies, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1004 Beau Terre Dr Ste 507, Bentonville, AR 72712 Phone: 479-903-1018 Fax: 855-738-7702 | |
Gregory Tubre, Md, Apmc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 811 Se 28th St, Suite 7, Bentonville, AR 72712 Phone: 479-271-2350 Fax: 479-271-0805 | |
Arkansas Phs Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 609 Sw 8th Street, Suite 600, Bentonville, AR 72712 Phone: 901-261-4848 Fax: 901-261-4849 |