DR. OTIS SUMTER WARR IV (NPI# 1043214323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043214323 |
| Entity Type | Individual |
| Full Name | DR. OTIS SUMTER WARR IV |
| Credential | M.D. |
| Practice Address |
555 W 6th St Mountain Home AR 72653-3409 |
| Practice Telephone | 8704258288 |
| Practice Fax Number | 8704258299 |
| Mailing Telephone | 8704258288 |
| Mailing Fax Number | 8704258299 |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2008-02-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | E3744 | AR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | QUAL CHOICE # | 03120015100 | 01 |
| AR | CHAMPUS/TRICARE # | A005 | 01 |
| AR | AR BCBS # | 5M662 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407805567 | Otis S Warr IIi | Internal Medicine | 6025 Walnut Grove Rd, Suite 607, Memphis, TN 38120-2131 | 2006-05-08 |
| Street Address |
555 W 6TH ST |
| City | MOUNTAIN HOME |
| State | AR |
| Zip Code | 72653-3409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487176764 | Leah Danielle Fountain | Nurse Practitioner | 555 W 6th St, Mountain Home, AR 72653-3409 | 2017-07-08 |
| 1629405113 | Baxter County Regional Hospital, Inc. | Internal Medicine | 555 W 6th St, Mountain Home, AR 72653-3409 | 2013-09-30 |
| 1790068773 | Kelli Michele Camp | Nurse Practitioner | 555 W 6th St, Mountain Home, AR 72653-3409 | 2011-09-26 |
| 1992083588 | Mountain Home Nephrology and Pulmonology Clinic | Internal Medicine | 555 W 6th St, Mountain Home, AR 72653-3409 | 2011-07-29 |
| 1669787784 | Brian Imbao Malte | Internal Medicine | 555 W 6th St, Mountain Home, AR 72653-3409 | 2010-08-12 |
| 1265614309 | Travis D Richardson, Do, Pllc | Orthopaedic Surgery | 555 W 6th St, Mountain Home, AR 72653-3409 | 2007-11-30 |
| 1356549901 | Jeffery D Tate | Physician Assistant | 555 W 6th St, Mountain Home, AR 72653-3409 | 2007-07-05 |
| 1861616021 | Sara Rebecca Martin | Internal Medicine | 555 W 6th St, Mountain Home, AR 72653-3409 | 2007-04-12 |
| 1275688616 | Louis W Elkins Md Pa | Clinic/Center | 555 W 6th St, Mountain Home, AR 72653-3409 | 2007-01-24 |
| 1558363622 | Michael James Camp | Specialist | 555 W 6th St, Mountain Home, AR 72653-3409 | 2005-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513934 | Maranda Hickman | Physical Therapy Assistant | 347 Hwy 62 East College Plaza, Mountain Home, AR 72653 | 2019-11-21 |
| 1659929156 | Gale E Bacan | Technician | 1703 Monroe Ave, Mountain Home, AR 72653 | 2019-08-28 |
| 1891259321 | Kidspiration Pediatric Therapy Services | Clinic/Center | 710 Bradley Dr., Mountain Home, AR 72653 | 2019-01-29 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| 1346769155 | Heather Bollinger | Nurse Practitioner | 65 Walmart Drive, C/o Clinic At Walmart, Mountain Home, AR 72653 | 2017-09-12 |
| 1447774989 | Natalie D Ahrent | Physical Medicine & Rehabilitation | 804 Coley Dr, Mountain Home, AR 72653 | 2017-07-26 |
| 1417486028 | Andrew David Hatman | Case Manager/Care Coordinator | 1349 Hampshire Circle, Mountain Home, AR 72653 | 2017-06-07 |
| 1568848315 | Taylor Chiropractic Plc | Health Maintenance Organization | 103 S Main St Ste 5, Mountain Home, AR 72653 | 2015-08-04 |
| 1942606306 | Harps Food Stores, Inc | Pharmacy | 2089 Highway 62 West, Mountain Home, AR 72653 | 2014-11-13 |
| 1972920726 | Lavonne Armstrong | Counselor | 8 Medical Plaza, Mountain Home, AR 72653 | 2014-03-18 |
| Find all providers in zip 72653 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528684370 | The Unruly Tongue Myofunctional Therapy LLC | Specialist | 1125 Nw Bluegrass Cir, Mountain Home, ID 83647 | 2020-06-17 |
| 1073716569 | Bruce D. Robbins, M.d. | Specialist | 1422 Highway 62 W, Mountain Home, AR 72653-4617 | 2007-06-11 |
| 1831305556 | Perry L Wilbur Md Pa | Specialist | 505 Hospital Dr, Mountain Home, AR 72653-2912 | 2007-05-16 |
| 1134341381 | Bruce Wolf Physical Therapy, P.a. | Specialist | 607 Northtown, Mountain Home, AR 72653-3121 | 2007-05-03 |
| 1700918471 | Physical Therapy Connection, Inc. | Specialist | 1027 Highway 62 E, Mountain Home, AR 72653-3215 | 2007-03-09 |
| 1790855518 | Linda P Woodbury | Specialist | 1200 Highway 201 N, Mountain Home, AR 72653-2440 | 2006-11-09 |
| 1831203512 | Stacey M Johnson Md Pa | Specialist | # 17 Medical Plaza, Mountain Home, AR 72653 | 2006-08-18 |
| 1215961859 | R. Harber Wood | Specialist | James H. Quillen/vamc (johnson City), Corner of Veterans Way and Lamont, Mountain Home, TN 37684 | 2006-07-10 |
| 1962454355 | Richard R Reece | Specialist | Sidney & Lamont Streets, V. A. Medical Center, Mountain Home, TN 37684 | 2006-05-16 |
| 1285602292 | Bruce Donald Robbins | Specialist | 1422 Hwy 62 Sw, Mountain Home, AR 72653-4617 | 2006-03-08 |
| Find all providers in MOUNTAIN HOME | ||||
| City | MOUNTAIN HOME |
| Zip Code | 72653 |
Please comment or provide details below to improve the information on DR. OTIS SUMTER WARR IV.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.