OZARK ORTHOPAEDICS, P.A. (NPI# 1235573577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235573577 |
| Entity Type | Organization |
| Organization Name | OZARK ORTHOPAEDICS, P.A. |
| Other Organization Name | OTHOPAEDIC CLINIC, LTD. |
| Practice Address |
1800 Se Moberly Ln Ste B Bentonville AR 72712-7017 |
| Mailing Address |
3317 N Wimberly Dr Fayetteville AR 72703-4056 |
| Practice Telephone | 4795212752 |
| Practice Fax Number | 4795214603 |
| Mailing Telephone | 4795212752 |
| Mailing Fax Number | 4795214603 |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2020-07-06 |
| Authorized Official Name | DR. TOM PAT COKER (PRESIDENT OF CORPORATION) |
| Authorized Official Telephone | 4795212752 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | OZARK ORTHOPAEDICS, P.A. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | CIGNA MEDICARE DURABLE MEDICAL EQUIPMENT PTAN | 0290210002 | 01 |
| Other Name | Type Code |
|---|---|
| Othopaedic Clinic, Ltd. | Former Legal Business Name - Organization |
| OZARK ORTHOPAEDICS | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 603-2 N Progress Ave, Siloam Springs, AR 727614063 | 4795246188 | 4795493733 |
| 146 Passion Play Rd Ste A, Eureka Springs, AR 726329455 | 4795212752 | 4795214603 |
| 3317 N Wimberly Dr, Fayetteville, AR 727034056 | 4795212752 | 4795214603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649614231 | Ozark Orthopaedics, P.a. | Physical Medicine & Rehabilitation | 603-2 N Progress Ave Ste 600, Siloam Springs, AR 72761-4610 | 2013-04-25 |
| 1649210584 | Ozark Orthopaedics, P.a. | Physical Medicine & Rehabilitation | 3317 N Wimberly Dr, Fayetteville, AR 72703-4056 | 2006-06-08 |
| Street Address |
1800 SE MOBERLY LN STE B |
| City | BENTONVILLE |
| State | AR |
| Zip Code | 72712-7017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528173697 | Gannon B Randolph | Orthopaedic Surgery | 1800 Se Moberly Ln, Bentonville, AR 72712-7017 | 2006-08-20 |
| 1104486976 | Forrest Blake Robinson | Physical Therapist | 1800 Se Moberly Ln, Bentonville, AR 72712-7017 | 2019-06-14 |
| 1750882890 | Kaitlyn Nicole Eastman | Physical Therapist | 1800 Se Moberly Ln, Bentonville, AR 72712-7017 | 2018-02-23 |
| 1336693084 | Brooke Nicole Warren | Physical Therapist | 1800 Se Moberly Ln, Bentonville, AR 72712-7017 | 2016-08-11 |
| 1942754957 | Jaime Valdes | Physical Therapist | 1800 Se Moberly Ln, Bentonville, AR 72712-7017 | 2016-08-08 |
| 1750835765 | Brynten Rayford | Physical Therapist | 1800 Se Moberly Ln, Bentonville, AR 72712-7017 | 2016-08-08 |
| 1467882084 | Laura Hadley Buergler | Physical Therapist | 1800 Se Moberly Ln, Bentonville, AR 72712-7017 | 2013-11-18 |
| 1821319856 | Robert Angus Macleod | Orthopaedic Surgery | 1800 Se Moberly Ln, Ste 4, Bentonville, AR 72712-7017 | 2010-06-14 |
| 1932436755 | Anthony Adair | Physical Therapist | 1800 Se Moberly Ln, Bentonville, AR 72712-7017 | 2009-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662345 | Bentonville Ambulatory Surgery Center, LLC | Pain Medicine | 2902 We Mid-cities Dr, Bentonville, AR 72712 | 2020-09-08 |
| 1942837059 | Amy Crumpton | Counselor | 3504 Se Riveria Road, Bentonville, AR 72712 | 2020-03-26 |
| 1295361509 | Unbridled Holdings LLC | Physical Therapy Assistant | 9900 Price Coffee Rd, Bentonville, AR 72712 | 2020-03-18 |
| 1649803552 | Hanna Kathryn Baxendale | Pediatrics | 2900 Medical Pkwy, Ste #370, Bentonville, AR 72712 | 2020-02-19 |
| 1740746635 | Meredith C Hodges | Counselor | 2508 Se 2oth St, Bentonville, AR 72712 | 2019-02-15 |
| 1609352566 | Tripharma Inc | Pharmacy | 3500 Sw Regional Airport Blvd Ste 2, Bentonville, AR 72712 | 2018-07-13 |
| 1811406747 | Upspring Therapy, LLC | Counselor | 2106 Sw Walton Blvd, Suite B, Bentonville, AR 72712 | 2017-09-22 |
| 1023536836 | Charlotte Yuvonne Hoyle | Case Manager/Care Coordinator | 2005 S.e Walton Blvd., Bentonville, AR 72712 | 2017-08-31 |
| 1508399502 | Rosanna Nicole Rephan | Nurse Practitioner | 3101 14th St, Mercy Convenient Care, Bentonville, AR 72712 | 2017-04-06 |
| 1417305517 | Charlotte Lennette Stephenson | Behavioral Analyst | 2005 S.e. Walton Blvd., Bentonville, AR 72712 | 2016-05-31 |
| Find all providers in zip 72712 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528173697 | Gannon B Randolph | Orthopaedic Surgery | 1800 Se Moberly Ln, Bentonville, AR 72712-7017 | 2006-08-20 |
| 1154938173 | James R Boyle Md, LLC | Orthopaedic Surgery | 1504 Se 28th St, Bentonville, AR 72712-3988 | 2020-09-24 |
| 1598325367 | Oark Care of Ar, LLC | Orthopaedic Surgery | 900 Se 5th St Ste 22, Bentonville, AR 72712-6090 | 2019-06-14 |
| 1386098101 | Innovative Orthopedic Solutions, Pllc | Orthopaedic Surgery | 1504 Se 28th St, Bentonville, AR 72712-3988 | 2016-04-18 |
| 1316230261 | Maline Orthopedics, Pllc | Orthopaedic Surgery | 1504 Se 28th St, Bentonville, AR 72712-3988 | 2011-05-25 |
| 1821319856 | Robert Angus Macleod | Orthopaedic Surgery | 1800 Se Moberly Ln, Ste 4, Bentonville, AR 72712-7017 | 2010-06-14 |
| 1639339112 | James Richard Boyle Jr. | Orthopaedic Surgery | 1504 Se 28th St, Bentonville, AR 72712-3988 | 2008-06-10 |
| 1700943636 | Mckenzie Orthopedic and Sports Clinic | Orthopaedic Surgery | 1504 Se 28th St, Bentonville, AR 72712-3988 | 2007-01-02 |
| 1568529295 | Arkansas Center for Arthroscopy, Pa | Orthopaedic Surgery | 1504 Se 28th St, Bentonville, AR 72712-3988 | 2007-01-02 |
| 1356408298 | Rodger C. Dickinson, Jr., M.d., Pa | Orthopaedic Surgery | 1504 Se 28th St, Bentonville, AR 72712-3988 | 2007-01-02 |
| Find all providers in BENTONVILLE | ||||
| City | BENTONVILLE |
| Zip Code | 72712 |
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| 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.