DR. SAM R. SHANLEVER (NPI# 1962598433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962598433 |
| Entity Type | Individual |
| Full Name | DR. SAM R. SHANLEVER |
| Credential | D.D.S. |
| Practice Address |
9755 W State Highway 22 Ratcliff AR 72951-9000 |
| Mailing Address |
Po Box 130 Ratcliff AR 72951-0130 |
| Practice Telephone | 4796355300 |
| Practice Fax Number | 4796352010 |
| Mailing Telephone | 4796355300 |
| Mailing Fax Number | 4796352010 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2010-03-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2285 | AR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 103823608 | 05 | |
| AR | BLUE CROSS BLUE SHIELD | 58898 | 01 |
| AR | UNITED CONCORDIA | 846647 | 01 |
| Street Address |
9755 W STATE HIGHWAY 22 |
| City | RATCLIFF |
| State | AR |
| Zip Code | 72951-9000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043290109 | River Valley Primary Care Services Inc | Clinic/Center | 9755 W State Highway 22, Ratcliff, AR 72951-9000 | 2006-01-17 |
| 1124634555 | River Valley Primary Care Services | Pharmacy | 9755 W State Highway 22, Ratcliff, AR 72951-9000 | 2020-09-21 |
| 1588138267 | Amber R Acord | Physician Assistant | 9755 W State Highway 22, Ratcliff, AR 72951-9000 | 2019-01-16 |
| 1750857066 | Thomas Donovan Kiefer | Dentist | 9755 W State Highway 22, Ratcliff, AR 72951-9000 | 2018-10-15 |
| 1578810487 | Colleen Jane Atchley | Nurse Practitioner | 9755 W State Highway 22, Ratcliff, AR 72951-9000 | 2012-08-09 |
| 1225296619 | River Valley Primary Care Services Inc | Clinic/Center | 9755 W State Highway 22, Ratcliff, AR 72951-9000 | 2008-06-02 |
| 1124195698 | John C Urban | Family Medicine | 9755 W State Highway 22, Ratcliff, AR 72951-9000 | 2006-11-29 |
| 1801996392 | Michael L Guyer | Family Medicine | 9755 W State Highway 22, Ratcliff, AR 72951 | 2006-09-24 |
| 1528088846 | Nathan Bennett | Internal Medicine | 9755 W State Highway 22, Ratcliff, AR 72951-9000 | 2006-07-20 |
| 1548204654 | Wendy A. Gaston | Nurse Practitioner | 9755 W State Highway 22, Ratcliff, AR 72951-9000 | 2006-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124035993 | Charles Woodrow Jones Jr. | Family Medicine | 9755 W St Hwy 22, Ratcliff, AR 72951 | 2006-08-02 |
| 1699707661 | Edward A Vela | Dentist | 9755 W State Hwy 22, Ratcliff, AR 72951 | 2006-07-07 |
| 1568466274 | Charles D Parker | Family Medicine | 9755 West State Hwy 22, Ratcliff, AR 72951 | 2005-06-09 |
| 1013010610 | Naomi Ruth Hawkins | Nurse Practitioner | 9755 W State Hwy 22, Ratcliff, AR 72951 | 2006-09-07 |
| 1841213238 | April Revis | Nurse Practitioner | 9755 West State Hwy 22, Ratcliff, AR 72951 | 2006-07-26 |
| 1780616755 | John R Williams | Family Medicine | 9755 W State Hwy 22, Ratcliff, AR 72951 | 2006-07-07 |
| 1295706182 | Theodora L Short | Nurse Practitioner | 9755 W. State Highway 22, Ratcliff, AR 72951-9000 | 2006-01-30 |
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750857066 | Thomas Donovan Kiefer | Dentist | 9755 W State Highway 22, Ratcliff, AR 72951-9000 | 2018-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043826944 | Atlas Dental Partners Pllc | Dentist | 3903 W Financial Pkwy, Rogers, AR 72758-1471 | 2020-09-17 |
| 1669086724 | Epic Smiles Pllc | Dentist | 310 E Centerton Blvd, Centerton, AR 72719 | 2020-09-04 |
| 1063023554 | Christopher Marshall | Dentist | 1804 Old Greensboro Rd Bldg B, Jonesboro, AR 72405-0003 | 2020-08-10 |
| 1790394393 | Robert W Bassham Dds Pa | Dentist | 669 Addison Dr, Wynne, AR 72396-1602 | 2020-07-29 |
| 1215545710 | Justin Michael Cooper | Dentist | 5008 S U St Ste 101a, Fort Smith, AR 72903-3613 | 2020-07-21 |
| 1740898584 | Jamie Beavers Dds, P.a. | Dentist | 354 Main Street, Clinton, AR 72031 | 2020-07-17 |
| 1144848490 | Abbey Lynn Norwood | Dentist | 5501 W Pinnacle Pointe Dr Ste 1, Rogers, AR 72758-8133 | 2020-07-13 |
| 1093332728 | Michael Drake | Dentist | 9601 Baptist Health Dr Ste 104, Little Rock, AR 72205-6323 | 2020-06-29 |
| 1235753682 | Drew Bannerman Dds, P.a. | Dentist | 4603 Fairway Ave, North Little Rock, AR 72116-8052 | 2020-06-02 |
| 1669021564 | Steven Michael Clark | Dentist | 1700 University Blvd Ste 105, Morrilton, AR 72110-8004 | 2019-09-04 |
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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.