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EXECUTIVE PARK SURGERY CENTER, LLC
NPI 1699736777
Clinic/Center - Ambulatory Surgical in Fort Smith, AR

Active since March 29, 2006
3314 S 70TH ST, FORT SMITH, AR 72903(479) 424-2744(479) 424-2745 Get Directions Write a Review

NPPES record last updated: December 16, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Executive Park Surgery Center, Llc NPPES

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

EXECUTIVE PARK SURGERY CENTER, LLC (NPI 1699736777) is a healthcare organization registered as an ambulatory surgical in Fort Smith, Arkansas and active in the NPI registry since March 2006. The organization lists Randy M Ennen, President, as its authorized official.

NPPES Registry Identity

NPI1699736777
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameEXECUTIVE PARK SURGERY CENTER, LLC
Location Address3314 S 70TH STFort Smith, AR 72903-5052
Mailing Address3314 S 70th StFort Smith, AR 72903-5052 · (479) 424-2744 · Fax (479) 424-2745
Phone(479) 424-2744
Fax(479) 424-2745
Organization SubpartNo
Authorized OfficialRandy M EnnenPresident · (479) 424-2744
Enumeration DateMarch 29, 2006
Last NPPES UpdateDecember 16, 2010
✔ NPI 1699736777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
3314 S 70TH ST, Fort Smith, AR 72903
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Other Identifiers 3

Medicare ID-Type Unspecified11059
Medicaid200041770AOK
Medicaid155824128AR

Accepted Insurance

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

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FRONTIER ANESTHESIA SERVICES, LLC
Nurse Anesthetist, Certified Registered
3314 S 70TH ST
FORT SMITH, AR 72903
Sebastian County (615) 620-2320
EXECUTIVE PARK SURGERY CENTER OF FORT SMITH, INC
Clinic/Center (Ambulatory Surgical)
3314 S 70TH ST
FORT SMITH, AR 72903
Sebastian County (479) 424-2744

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 Executive Park Surgery Center, LLC's NPI number?

The NPI number for Executive Park Surgery Center, LLC is 1699736777. It was assigned to this organization in the NPPES registry on March 29, 2006.

Where is Executive Park Surgery Center, LLC located?

Executive Park Surgery Center, LLC is located at 3314 S 70th St, Fort Smith, AR 72903. The listed phone number is (479) 424-2744.

What is Executive Park Surgery Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

What insurance does Executive Park Surgery Center, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Executive Park Surgery Center, LLC 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 Executive Park Surgery Center, LLC was last updated on December 16, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.