| Selah Health | |
|
180 S Thornton Ave Piggott AR 72454-2731 | |
| (870) 970-3180 | |
| (870) 343-6262 |
| Full Name | Selah Health |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 180 S Thornton Ave, Piggott, Arkansas |
| Authorized Official Name and Position | Amanda Gail Smallmon (CEO) |
| Authorized Official Contact | 8709703180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Selah Health Po Box 301 Piggott AR 72454-0301 Ph: (870) 970-3180 | Selah Health 180 S Thornton Ave Piggott AR 72454-2731 Ph: (870) 970-3180 |
| NPI Number | 1720734247 |
|---|---|
| Provider Enumeration Date | 02/23/2022 |
| Last Update Date | 05/11/2024 |
| Certification Date | 05/11/2024 |
| Medicare PECOS PAC ID | 5395130546 |
|---|---|
| Medicare Enrollment ID | O20220324002295 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720734247 | NPI | - | NPPES |
| 1447481072 | Other | AMANDA SMALLMON'S NPI # | |
| 1518246438 | Other | TAMMY TRIPP, LSCW, NPI# | |
| 291504758 | Medicaid | AR |
| Provider Name | Amanda G Smallmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447481072 PECOS PAC ID: 7416002621 Enrollment ID: I20090910000634 |
| Provider Name | Emily B Carpenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780035998 PECOS PAC ID: 6204122302 Enrollment ID: I20160915000507 |
| Provider Name | Tammy Tripp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518246438 PECOS PAC ID: 8820328776 Enrollment ID: I20190919002204 |
| Provider Name | Katheryn Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659377752 PECOS PAC ID: 3476568262 Enrollment ID: I20221020000752 |
| Provider Name | Bridgette J Fielder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083873012 PECOS PAC ID: 6709234685 Enrollment ID: I20240201003618 |
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