UNIVERSITY OF ARKANSAS AT MONTICELLO (NPI# 1083269690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083269690 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF ARKANSAS AT MONTICELLO |
| Practice Address |
663 University Drive Monticello AR 71656 |
| Mailing Address |
5050 Spring Valley Rd Dallas TX 75244-3995 |
| Practice Telephone | 8704601058 |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |
| Authorized Official Name | MOUZON BASS III (ADMINISTRATOR/AGENT) |
| Authorized Official Telephone | 9723674845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UAM Sports Medicine | Doing Business As Name - Organization |
| Street Address |
663 UNIVERSITY DRIVE |
| City | MONTICELLO |
| State | AR |
| Zip Code | 71656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639730401 | Shellye Karen Byrd | Specialist/Technologist | 135 Forestry Park Drive, Monticello, AR 71656 | 2019-06-24 |
| 1346742806 | Yohei Shimozaki | Specialist/Technologist | 605 University Dr, Monticello, AR 71656 | 2018-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508722 | Tlc Healthcare LLC | Nurse Practitioner | 202 N Main St Ste A, Monticello, IA 52310-1746 | 2020-11-06 |
| 1548860265 | Clinton Brad Wilson | Pharmacist | 650 Hiawatha Farms Rd, Monticello, FL 32344-0821 | 2020-10-30 |
| 1457968406 | Sojnia Irene Johnson | Nurse Practitioner | 561 Country Oaks Ln, Monticello, KY 42633-5145 | 2020-09-24 |
| 1023622081 | Marty Kyle Ballard Sr. | Nurse Practitioner | 698 Lower Brookhaven Rd, Monticello, MS 39654-9627 | 2020-09-06 |
| 1346854023 | Julia Lynn Waldorf | Student in an Organized Health Care Education/Training Program | 141 Benmosche Road, Monticello, NY 12701 | 2020-09-01 |
| 1134731292 | Benjamin Wolsey Nielson | Social Worker | 133 E. 200 S., Monticello, UT 84535 | 2020-08-20 |
| 1457963431 | Morgan Dishman | Pharmacist | 126 Franklin Dr, Monticello, KY 42633 | 2020-08-20 |
| 1720690027 | Brynwood Operations LLC | Skilled Nursing Facility | 1656 S Jefferson St, Monticello, FL 32344-1652 | 2020-08-18 |
| 1245841949 | Nathan Macolly | Social Worker | 205 N Rhodes St, Monticello, FL 32344-2558 | 2020-08-14 |
| 1518576966 | Whitney Ann Mcknight | Occupational Therapist | 345 Mims Rd, Monticello, FL 32344-5613 | 2020-07-30 |
| Find all providers in MONTICELLO | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003078056 | Carol Bridges | General Practice | 4391 E Lake Rd 36e, Monticello, IN 47960-7513 | 2008-07-01 |
| 1962670802 | Edmundo C Aquino | General Practice | 215 E Wisconsin Ave, Monticello, WI 53570-9632 | 2008-02-13 |
| 1336334796 | Sigma Medical Group, LLC | General Practice | 902 Foxwood Ct, Monticello, IN 47960-3201 | 2007-09-10 |
| 1457573495 | Herman Goldfarb | General Practice | 109 Starlight Rd, Monticello, NY 12701-4032 | 2007-05-02 |
| 1487891552 | Mel Charles Hartsfield | General Practice | 1255 W Washington St, Monticello, FL 32344-1128 | 2009-01-12 |
| 1548455090 | Catskill Adult & Ped Med | General Practice | 64 Jefferson St, Suite 2, Monticello, NY 12701-1148 | 2007-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790382059 | Landmark Medical of Arkansas Pa | General Practice | 425 W Capitol Ave Ste 425, Little Rock, AR 72201-3424 | 2020-10-08 |
| 1306480231 | Command Radiology Solutions, Inc. | General Practice | 3708 Pilot Grove Loop, Ozark, AR 72949-2488 | 2019-11-04 |
| 1215586797 | Achor Management Inc | General Practice | 1900 Club Manor Dr Ste 101a, Maumelle, AR 72113-7443 | 2019-09-08 |
| 1093364820 | Center for Regenerative Medicine Pa | General Practice | 9307 Maumelle Blvd, North Little Rock, AR 72113-6609 | 2019-09-04 |
| 1912492786 | Chelsea Brown | General Practice | 6309 Highway 5 N, Bryant, AR 72022-8506 | 2018-06-25 |
| 1205345154 | Lakeside Walk-in Clinic Pllc | General Practice | 2230 Malvern Ave Ste E, Hot Springs, AR 71901-8000 | 2017-09-22 |
| 1558897595 | Epoch-nwa Pllc | General Practice | 5100 W Pauline Whitaker Pkwy, Ste. 110, Rogers, AR 72758-8335 | 2017-05-11 |
| 1023540655 | Aaron M Smith | General Practice | Varner Unit State Hwy 388, Gould, AR 71643 | 2017-04-02 |
| 1942749148 | Reece Lewis Crow | General Practice | 34 Windsor Road, Little Rock, AR 72212 | 2017-02-21 |
| 1003360082 | Healthmax Center LLC | General Practice | 12300 Highway 71 S, Suite A, Fort Smith, AR 72916-9133 | 2016-08-08 |
| Find all providers with the same taxonomy | ||||
| City | MONTICELLO |
| Zip Code | 71656 |
Please comment or provide details below to improve the information on UNIVERSITY OF ARKANSAS AT MONTICELLO.
| 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.