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OZARK SURGICAL GROUP
NPI 1336155167
Surgery in Mountain Home, AR

Active since August 01, 2006
901 BURNETT DR, MOUNTAIN HOME, AR 72653(870) 425-9120 Get Directions Write a Review

NPPES record last updated: April 28, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ozark Surgical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OZARK SURGICAL GROUP (NPI 1336155167) is a healthcare organization registered as a surgery in Mountain Home, Arkansas and active in the NPI registry since August 2006. The organization lists Susan Marie Smith, Coding & Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1336155167
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameOZARK SURGICAL GROUP
Location Address901 BURNETT DRMountain Home, AR 72653-2908
Mailing Address901 Burnett DrMountain Home, AR 72653-2908 · (870) 425-9120
Phone(870) 425-9120
Organization SubpartNo
Authorized OfficialSusan Marie SmithCoding & Billing Manager · (870) 425-9120
Enumeration DateAugust 1, 2006
Last NPPES UpdateApril 28, 2022
NPPES CertifiedApril 28, 2022
✔ NPI 1336155167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
901 BURNETT DR, Mountain Home, AR 72653
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Other Identifiers 1

Medicaid101039002AR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ozark Surgical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateArkansasEnrollment IDO20070426000280Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Ozark Surgical Group, which bills Medicare for the services they deliver. Of these, 9 practice at this address. They are listed nearest first.

Clinicians, nearest first (9)

Nathaniel Blanton, APRN
Nurse Practitioner
NPI 1891308839
901 BURNETT DR
Mountain Home, AR 72653
(870) 425-9120
✔ PECOS✔ Accepts MedicareSame address
John Carlisle, D.O.
General Surgery
NPI 1164962726
901 BURNETT DR
Mountain Home, AR 72653
(870) 421-9120
✔ PECOS✔ Accepts MedicareSame address
Isabella Guajardo, MD
General Surgery
NPI 1811550742
901 BURNETT DR
Mountain Home, AR 72653
(912) 087-0421
✔ PECOS✔ Accepts MedicareSame address
David Harrison, M.D.
General Surgery
NPI 1427157478
901 BURNETT DR
Mountain Home, AR 72653
(870) 425-9120
✔ PECOS✔ Accepts MedicareSame address
Anastasios Mitsakos, MD
Surgical Oncology
NPI 1093236564
901 BURNETT DR
Mountain Home, AR 72653
(870) 425-9120
✔ PECOS✔ Accepts MedicareSame address
Megan Terry, ANP
Nurse Practitioner
NPI 1659653558
901 BURNETT DR
Mountain Home, AR 72653
(870) 425-9120
✔ PECOS✔ Accepts MedicareSame address
Jacob Dickinson, MD
General Surgery
NPI 1396866364
901 BURNETT DR
Mountain Home, AR 72653
(870) 425-9120
✔ PECOS✔ Accepts MedicareSame address
Jennifer Foster, M.D.
General Surgery
NPI 1356579510
901 BURNETT DR
Mountain Home, AR 72653
(870) 425-9120
✔ PECOS✔ Accepts MedicareSame address
Isaac Gaston, APRN
Nurse Practitioner
NPI 1457850372
901 BURNETT DR
Mountain Home, AR 72653
(870) 425-9120
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently 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 Ozark Surgical Group's NPI number?

The NPI number for Ozark Surgical Group is 1336155167. It was assigned to this organization in the NPPES registry on August 1, 2006.

Where is Ozark Surgical Group located?

Ozark Surgical Group is located at 901 Burnett Dr, Mountain Home, AR 72653. The listed phone number is (870) 425-9120.

What is Ozark Surgical Group's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Ozark Surgical Group enrolled in Medicare?

Yes. Ozark Surgical Group is registered in the Medicare PECOS enrollment system.

When is Ozark Surgical Group's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arkansas, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Ozark Surgical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 3 Medicare specialties reassign their Medicare billing to Ozark Surgical Group. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are General Surgery (5), Nurse Practitioner (3) and Surgical Oncology (1). Of these, 9 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Ozark Surgical Group accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Ozark Surgical Group as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ozark Surgical Group was last updated on April 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.