| |
899 Burnett Dr Mountain Home AR 72653-2909 | |
(870) 425-6212 | |
(870) 508-6896 |
Full Name | |
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Speciality | Family Medicine |
Location | 899 Burnett Dr, Mountain Home, Arkansas |
Authorized Official Name and Position | Debra Henry (CFO) |
Authorized Official Contact | 8705081003 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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899 Burnett Dr Mountain Home AR 72653-2909 Ph: (870) 425-6212 | 899 Burnett Dr Mountain Home AR 72653-2909 Ph: (870) 425-6212 |
NPI Number | 1851725139 |
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Provider Enumeration Date | 08/22/2013 |
Last Update Date | 01/06/2021 |
Medicare PECOS PAC ID | 0042389264 |
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Medicare Enrollment ID | O20120326000509 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851725139 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Provider Name | Witold P Czerwinski |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1710952270 PECOS PAC ID: 6204735913 Enrollment ID: I20031231000731 |
Provider Name | Tamra Ward |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205937695 PECOS PAC ID: 8729086616 Enrollment ID: I20070220000745 |
Provider Name | Raymond L Bandy |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1265411318 PECOS PAC ID: 5890746382 Enrollment ID: I20070316000131 |
Provider Name | John T Leslie |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760426746 PECOS PAC ID: 7517936214 Enrollment ID: I20080325000179 |
Provider Name | Lori M Cheney |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1497712293 PECOS PAC ID: 0042213472 Enrollment ID: I20090302000339 |
Provider Name | Kam S Lie |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1578632485 PECOS PAC ID: 3779771811 Enrollment ID: I20101216000371 |
Provider Name | Stacy A Emerson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942508999 PECOS PAC ID: 4880870757 Enrollment ID: I20110511000346 |
Provider Name | Grant Kohler Mathews |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1689898843 PECOS PAC ID: 7719150572 Enrollment ID: I20111024000563 |
Provider Name | Sara R Martin |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1861616021 PECOS PAC ID: 7113190034 Enrollment ID: I20111207000222 |
Provider Name | Leslie L Batterton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477898021 PECOS PAC ID: 6305081373 Enrollment ID: I20130321000414 |
Provider Name | Brian I Malte |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1669787784 PECOS PAC ID: 9830406859 Enrollment ID: I20150923001301 |
Provider Name | Whitney Reed |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710361464 PECOS PAC ID: 9830408541 Enrollment ID: I20151020002609 |
Provider Name | Ashley D Johnson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1497992440 PECOS PAC ID: 6800170556 Enrollment ID: I20170225000068 |
Provider Name | Joyce L Stratmoen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841736170 PECOS PAC ID: 1355625765 Enrollment ID: I20170303000298 |
Provider Name | Dahlia D Distin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346472941 PECOS PAC ID: 8527335249 Enrollment ID: I20170601000597 |
Provider Name | Benjamin Stevens |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215341656 PECOS PAC ID: 1850517434 Enrollment ID: I20170815000833 |
Provider Name | Amanda Shawn Whitaker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295235331 PECOS PAC ID: 4981940400 Enrollment ID: I20190103003010 |
Provider Name | Brittney Woodward Frisby |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235589748 PECOS PAC ID: 7618265562 Enrollment ID: I20190918001924 |
Provider Name | Veronica Zak |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1003097841 PECOS PAC ID: 3779672308 Enrollment ID: I20191030001942 |
Provider Name | Phillippa Jane Arnold |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376173229 PECOS PAC ID: 2264860964 Enrollment ID: I20200311001754 |
Provider Name | Tracie Lane Gilliland |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568082006 PECOS PAC ID: 0547686826 Enrollment ID: I20200818000027 |
Provider Name | Shannon R Caraway |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1841602141 PECOS PAC ID: 5698192953 Enrollment ID: I20200901001496 |
Provider Name | Angela Jean Beyer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457978173 PECOS PAC ID: 4183035892 Enrollment ID: I20201202001500 |
Provider Name | Shannon Castle |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699123562 PECOS PAC ID: 1052714730 Enrollment ID: I20210720000748 |
Provider Name | Michelle Lynn Marcak |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508439456 PECOS PAC ID: 4880098441 Enrollment ID: I20210804003467 |
Provider Name | Whitney Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780966127 PECOS PAC ID: 4981936382 Enrollment ID: I20210814000315 |
Provider Name | Mary Candace Depper |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306375084 PECOS PAC ID: 0446657506 Enrollment ID: I20210916002338 |
Provider Name | Emily Jane Garrett-pruett |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952503690 PECOS PAC ID: 1254426836 Enrollment ID: I20220428001042 |
Provider Name | Chesley Hardin Murphy |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508493610 PECOS PAC ID: 4183042054 Enrollment ID: I20230822001854 |
Regional Family Medicine Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 630 Burnett Dr, Mountain Home, AR 72653 Phone: 870-425-6971 Fax: 870-508-8900 | |
Yourpersonalmd.com Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 S College St, Suite 3, Mountain Home, AR 72653 Phone: 870-424-9763 Fax: 870-424-9762 | |