BENTONVILLE ENDOSCOPY CENTER, LLC
NPI 1013731397
Clinic/Center - Ambulatory Surgical in Bentonville, AR
About Bentonville Endoscopy Center, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BENTONVILLE ENDOSCOPY CENTER, LLC (NPI 1013731397), doing business as Bentonville Endoscopy Center, is a healthcare organization registered as an ambulatory surgical in Bentonville, Arkansas and active in the NPI registry since November 2024. The organization holds a CLIA Waiver certificate valid through December 19, 2026 and lists Kelly Rouvaldt, Director Of Ascs, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 04D2315853
Bentonville Endoscopy Center LLC · Bentonville, ARFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Bentonville Endoscopy Center, LLC's NPI number?
The NPI number for Bentonville Endoscopy Center, LLC is 1013731397. It was assigned to this organization in the NPPES registry on November 13, 2024. The provider is doing business as Bentonville Endoscopy Center.
Where is Bentonville Endoscopy Center, LLC located?
Bentonville Endoscopy Center, LLC is located at 3700 SE Dodson Road Suite #4, Bentonville, AR 72712. The listed phone number is (817) 893-2381.
What is Bentonville Endoscopy Center, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.
Does Bentonville Endoscopy Center, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D2315853) is associated with this NPI, valid through December 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Bentonville Endoscopy Center, LLC was last updated on November 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Bentonville Endoscopy Center, Llc · NPI 1013731397
Ambulatory Surgical organization in Bentonville, Arkansas. Organization record, active in the CMS NPPES registry since November 13, 2024.
## Identity
- **NPI:** 1013731397 (Entity type: Organization)
- **Enumerated:** November 13, 2024
- **Primary specialty:** Clinic/Center - Ambulatory Surgical · taxonomy 261QA1903X
- **Also known as:** Bentonville Endoscopy Center (Doing Business As)
- **Organization subpart:** Yes (part of The Gi Alliance Acquisition, Llc)
- **Authorized official:** Kelly Rouvaldt, DIRECTOR OF ASCS
## Practice location
- **Address:** 3700 SE DODSON ROAD, SUITE #4, Bentonville, AR 72712
- **Phone:** (817) 893-2381
## Record status
- **NPPES last updated:** November 13, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1013731397) · Data from the CMS NPPES public registry.