| Austin J Black, CRNA | |
| 
					2710 S Rife Medical Ln, Rogers, AR 72758-1452  | |
| (479) 338-8000 | |
| (479) 338-3056 | 
| Full Name | Austin J Black | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Anesthetist, Certified Registered | 
| Location | 2710 S Rife Medical Ln, Rogers, Arkansas | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1669171849 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 163W00000X | Registered Nurse | 2016021022 (Missouri) | Secondary | 
| 367500000X | Nurse Anesthetist, Certified Registered | 225111 (Arkansas) | Primary | 
| Entity Name | Anesthesia Services Of Benton County Pa | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1013084482 PECOS PAC ID: 2264405844 Enrollment ID: O20040813000287  | 
| Entity Name | Renew Medical Group Of Arkansas Ltd | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1215755947 PECOS PAC ID: 3173056298 Enrollment ID: O20241029000873  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Austin J Black, CRNA Po Box 507, Lowell, AR 72745-0507 Ph: (913) 647-4100  | Austin J Black, CRNA 2710 S Rife Medical Ln, Rogers, AR 72758-1452 Ph: (479) 338-8000  | 
Steven Derek Ceola, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2710 Rife Medical Ln, Rogers, AR 72758 Phone: 913-381-5200 Fax: 913-381-0979  | |
Matthew W Shelby, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2710 Rife Medical Ln, Anesthesia Dept, Rogers, AR 72758 Phone: 913-642-4900 Fax: 913-381-0979  | |
Helen Leighann Hong,  Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2710 S Rife Medical Ln, Rogers, AR 72758 Phone: 479-338-8000  | |
Chad Silvey, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2710 S Rife Medical Ln, Rogers, AR 72758 Phone: 479-338-8000 Fax: 479-338-3056  | |
Dr. Brandon Jay Edmondson, DNAP, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2710 S Rife Medical Ln, Rogers, AR 72758 Phone: 801-500-2475  | |
Julianna Felter,  Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2710 S Rife Medical Ln, Rogers, AR 72758 Phone: 479-338-8000  | |
Sean P Mccarthy, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1200 W Walnut St, Rogers, AR 72756 Phone: 479-636-0200 Fax: 479-936-2912  |