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NORTHWEST ARKANSAS FUNCTIONAL HEALTH LLC
NPI 1417669029
Nurse Practitioner in Tontitown, AR

Active since December 15, 2022
246 S MAESTRI RD STE 2, TONTITOWN, AR 72762(479) 220-9909(888) 675-9637 Get Directions Write a Review

NPPES record last updated: December 15, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Northwest Arkansas Functional Health Llc NPPES

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

NORTHWEST ARKANSAS FUNCTIONAL HEALTH LLC (NPI 1417669029) is a healthcare organization registered as a nurse practitioner in Tontitown, Arkansas and active in the NPI registry since December 2022. The organization lists Brent Rush, Arpn, as its authorized official.

NPPES Registry Identity

NPI1417669029
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameNORTHWEST ARKANSAS FUNCTIONAL HEALTH LLC
Location Address246 S MAESTRI RD STE 2Tontitown, AR 72762-9703
Mailing Address20398 Bill Young RdSiloam Springs, AR 72761-8921 · (479) 220-9909 · Fax (888) 675-9637
Phone(479) 220-9909
Fax(888) 675-9637
Organization SubpartNo
Authorized OfficialBrent RushArpn · (479) 220-9951
Enumeration DateDecember 15, 2022
NPPES CertifiedDecember 15, 2022
✔ NPI 1417669029 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
246 S MAESTRI RD STE 2, Tontitown, AR 72762
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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 MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Northwest Arkansas Functional Health Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Northwest Arkansas Functional Health LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Brent Rush
Nurse Practitioner
NPI 1184072258
246 S MAESTRI RD STE 2
Tontitown, AR 72762
(479) 220-9909
✔ 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 Northwest Arkansas Functional Health LLC's NPI number?

The NPI number for Northwest Arkansas Functional Health LLC is 1417669029. It was assigned to this organization in the NPPES registry on December 15, 2022.

Where is Northwest Arkansas Functional Health LLC located?

Northwest Arkansas Functional Health LLC is located at 246 S Maestri Rd Ste 2, Tontitown, AR 72762. The listed phone number is (479) 220-9909.

What is Northwest Arkansas Functional Health LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Northwest Arkansas Functional Health LLC enrolled in Medicare?

Yes. Northwest Arkansas Functional Health LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Northwest Arkansas Functional Health LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Northwest Arkansas Functional Health LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Northwest Arkansas Functional Health LLC was last updated on December 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.