NORTHWEST ARKANSAS RENAL DIALYSIS ASSOCIATES


Address: 1104 Se 30th St, Bentonville, AR 72712-4290
Phone: 4796576220

NORTHWEST ARKANSAS RENAL DIALYSIS ASSOCIATES (NPI# 1396856084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396856084
Entity Type Organization
Organization Name NORTHWEST ARKANSAS RENAL DIALYSIS ASSOCIATES
Other Organization Name REGIONAL KIDNEY CENTER BENTONVILLE DIALYSIS CLINIC
Practice Address 1104 Se 30th St
Bentonville
AR 72712-4290
Mailing Address 509 E Millsap Rd
Suite 111
Fayetteville
AR 72703-4067
Practice Telephone 4796576220
Practice Fax Number 4796576229
Mailing Telephone 4794436688
Mailing Fax Number 4795279917
Enumeration Date 2006-08-31
Last Update Date 2008-03-19
Authorized Official Name DR. FRED SMARDO (BUISNESS OWNER)
Authorized Official Telephone 4794436688
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RN0300X Internal Medicine
Specialization: Nephrology
E2362 AR Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AR BCBS 12540 01

Other Provider/Organization Names

Other Name Type Code
Regional Kidney Center Bentonville Dialysis Clinic Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1194836874 Northwest Arkansas Renal Dialysis Associates Internal Medicine 708 Quandt Ave, Springdale, AR 72764-5309 2006-08-31
1598876278 Northwest Arkansas Renal Dialysis Associates Internal Medicine 500 S Mount Olive St, Suite 107, Siloam Springs, AR 72761-3602 2006-08-31
1154435923 Northwest Arkansas Renal Dialysis Associates Internal Medicine 509 E Millsap Rd, Suite 111, Fayetteville, AR 72703-4067 2006-08-18

Office Location

Street Address 1104 SE 30TH ST
City BENTONVILLE
State AR
Zip Code 72712-4290

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306024294 Total Renal Care Inc Clinic/Center 1104 Se 30th St, Bentonville, AR 72712-4290 2008-02-04

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RN0300X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Nephrology

Taxonomy Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639487564 Shamsul Alam Md Pa Internal Medicine 2618 Se J St, Suite#4, Bentonville, AR 72712-3767 2010-09-14
1912953373 Shamsul Alam Internal Medicine 2618 Se J St, Suite # 2 & 4, Bentonville, AR 72712-3767 2006-05-26

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1083075121 Ronald Hughes Internal Medicine 4919 Stonewall Rd, Little Rock, AR 72207-4735 2016-03-17
1578806477 Washington Regional Medical System Internal Medicine 813 Founders Park Dr E Ste 203, Springdale, AR 72762-6314 2013-03-29
1194909325 Umbar Ghaffar Internal Medicine 813 Founders Park Drive, Suite 203, Springdale, AR 72762-6314 2007-12-24
1588845259 Nephrology Associates, PC Internal Medicine 1409 E Moultrie Dr, Blytheville, AR 72315-6855 2007-11-21
1255543278 Prajwal Chevireddy Internal Medicine 9601 Baptist Health Dr Ste 350, Little Rock, AR 72205-6356 2007-05-03
1538383799 Adam Woodruff Internal Medicine 4802 E. Johnson Ave, Jonesboro, AR 72401 2007-04-12
1376665646 Drew Courtney Heiple Internal Medicine 115 Wrights St Ste C, Hot Springs National Park, AR 71913-6240 2007-04-06
1174608905 Daniel P Chock Internal Medicine 503 S College St, Mountain Home, AR 72653 2006-10-27
1942308101 Gregory P. Mock Internal Medicine 403 S Poplar St Ste D, Searcy, AR 72143-6000 2006-09-20
1932202819 Muhammad G Alam Internal Medicine 500 S University Ave Ste 508, Little Rock, AR 72205-5306 2006-09-06
Find all providers with the same taxonomy

Competitor

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City BENTONVILLE
Zip Code 72712

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Dataset Information

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.

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