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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
E2362 | AR | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | BCBS | 12540 | 01 |
Other Name | Type Code |
---|---|
Regional Kidney Center Bentonville Dialysis Clinic | Doing Business As Name - Organization |
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 |
Street Address |
1104 SE 30TH ST |
City | BENTONVILLE |
State | AR |
Zip Code | 72712-4290 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306024294 | Total Renal Care Inc | Clinic/Center | 1104 Se 30th St, Bentonville, AR 72712-4290 | 2008-02-04 |
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 | 207RN0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Nephrology |
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. |
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 |
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 |
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.