DAVID M STREET (NPI# 1487252755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487252755 |
Entity Type | Individual |
Full Name | DAVID M STREET |
Credential | PA |
Practice Address |
2010 Active Way Benton AR 72022-9267 |
Practice Telephone | 5013150984 |
Practice Fax Number | 5018471405 |
Mailing Telephone | 5013150984 |
Mailing Fax Number | 5018471405 |
Enumeration Date | 2020-10-09 |
Last Update Date | 2020-10-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PT2020058 | AR | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | ARKANSAS STATE LICENSE | PT2020-058 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114358470 | David Richard Street | Chiropractor | 3000 Market St Ne Ste 268, Salem, OR 97301-1809 | 2013-12-11 |
1972549103 | David Carey Street | Dentist | 2200 Mchenry Ave, Suite B, Modesto, CA 95350-3256 | 2006-06-22 |
1932529096 | David Street | Case Manager/Care Coordinator | 2150 Stockton Blvd, Sacramento, CA 95817-1337 | 2014-04-16 |
1902953797 | David Street | Otolaryngology | 1601 23rd Ave S, Suite 3050, Nashville, TN 37212-3182 | 2007-01-04 |
1326129545 | David Lee Street | Surgery | 520 Medical Center Dr, Ste 300, Medford, OR 97504-4316 | 2006-10-17 |
Street Address |
2010 ACTIVE WAY |
City | BENTON |
State | AR |
Zip Code | 72022-9267 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073596086 | Richard Dale Stevens | Physical Therapist | 2010 Active Way, Benton, AR 72019-0000 | 2005-11-23 |
1285141333 | Danny D Satterfield | Physician Assistant | 2010 Active Way, Benton, AR 72022-9267 | 2018-01-10 |
1376792457 | Jasmin Ann Lease | Physician Assistant | 2010 Active Way, Benton, AR 72019-7566 | 2008-09-15 |
1790952406 | Jeffrey S Johnson | Orthopaedic Surgery | 2010 Active Way, Benton, AR 72022-9267 | 2008-05-12 |
1336368661 | Mark S Bailey Jr. | Orthopaedic Surgery | 2010 Active Way, Benton, AR 72019-7566 | 2007-04-25 |
1952412892 | Donald Scott Walsh | Orthopaedic Surgery | 2010 Active Way, Benton, AR 72019-7566 | 2006-08-31 |
1093825002 | Saline Orthopedic Group P A | Orthopaedic Surgery | 2010 Active Way, Benton, AR 72022-9267 | 2006-08-30 |
1922082684 | Ralph D Cash | Orthopaedic Surgery | 2010 Active Way, Benton, AR 72019-7566 | 2005-12-05 |
1336123512 | Jerry J Lorio | Orthopaedic Surgery | 2010 Active Way, Benton, AR 72019-7566 | 2005-12-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922608868 | Lindsay Paige Macphee | Behavior Technician | 22461-i-30 Frontage Road, Bryant, AR 72022 | 2020-10-29 |
1952913469 | Kaleigh Angleton | Pharmacist | 5500 Ar-5, Bryant, AR 72022 | 2020-08-18 |
1851937254 | Lonnell O Seamster Sr. | Nurse Practitioner | 501 Woody Drive, Alexander, AR 72022 | 2019-11-20 |
1366098998 | Hannah Marie London | Occupational Therapist | 350 School Drive, Bryant, AR 72022 | 2019-08-09 |
1356996987 | Micah Self | Occupational Therapy Assistant | 200 Nw 4th Street, Bryant, AR 72022 | 2019-08-09 |
1114437548 | Samantha Lee Davis | Behavioral Analyst | 22461 I-30 Frontage Rd, 1100b, Bryant, AR 72022 | 2017-10-12 |
1164962171 | Healthcare Express, LLP | Clinic/Center | 23150 I-30 N, Bryant, AR 72022 | 2017-02-24 |
1205283223 | V & S Xpress LLC | Non-emergency Medical Transport (VAN) | 719 Sedgefield, Bryant, AR 72022 | 2016-05-19 |
1467877969 | Arkansas Maxillofacial Surgery Center | Dentist | 411 Office Park Dr, Bryant, AR 72022 | 2014-02-20 |
1558614511 | Melissa Robertson | Audiologist | 501 Jack Stephens Dr #547-05, Little Rock, AR 72022 | 2012-10-16 |
Find all providers in zip 72022 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033650817 | Dickson Orthopedics, Pa | Physician Assistant | 1416 E Matthews, Suite 200, Jonesboro, AR 72401-4632 | 2017-03-14 |
1912455387 | Anthony D Long Jr. | Physician Assistant | 17 Mockingbird Ln, Pine Bluff, AR 71603-6107 | 2016-09-14 |
1215233887 | Joshua Anthony Trinkle | Physician Assistant | 224 W. Erie Ave, Harrison, AR 72601 | 2011-01-31 |
1831391655 | Mandy Suzanne Mooneyham | Physician Assistant | 3053 N College Ave, Fayetteville, AR 72703-3417 | 2007-06-04 |
1407460843 | Alexandra Paige Brown | Physician Assistant | 1695 E Rainforest Rd, Fayetteville, AR 72703-5385 | 2020-09-02 |
1881158517 | Jordan Lane Milam | Physician Assistant | 5 Saint Vincent Cir Ste 100, Little Rock, AR 72205-5415 | 2019-01-28 |
1790252286 | Allison Henry | Physician Assistant | 4301 W Markham St, Little Rock, AR 72205-7101 | 2018-11-01 |
1649755133 | Hillary Michelle Mayberry | Physician Assistant | 4301 W Markham St, Little Rock, AR 72205-7101 | 2018-10-01 |
1013417518 | Corey Carver | Physician Assistant | 1000 S 52nd St, Rogers, AR 72758-8610 | 2018-02-20 |
1316485857 | Farrah Jennings | Physician Assistant | 1000 S. 52nd Street, Rogers, AR 72758 | 2017-02-04 |
Find all providers with the same taxonomy |
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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.