| Northwest Arkansas Family Medicine And Obstetrics | |
|
2000 S Promenade Blvd Suite 202 Rogers AR 72758-9073 | |
| (479) 282-2737 | |
| (479) 316-4072 |
| Full Name | Northwest Arkansas Family Medicine And Obstetrics |
|---|---|
| Speciality | Family Medicine |
| Location | 2000 S Promenade Blvd, Rogers, Arkansas |
| Authorized Official Name and Position | Nicole Scally (CHAIRMAN/PRESIDENT/SECRETARY) |
| Authorized Official Contact | 4792822737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Arkansas Family Medicine And Obstetrics 2000 S Promenade Blvd Suite 202 Rogers AR 72758-9073 Ph: (479) 282-2737 | Northwest Arkansas Family Medicine And Obstetrics 2000 S Promenade Blvd Suite 202 Rogers AR 72758-9073 Ph: (479) 282-2737 |
| NPI Number | 1891186193 |
|---|---|
| Provider Enumeration Date | 02/09/2015 |
| Last Update Date | 03/11/2016 |
| Medicare PECOS PAC ID | 8527368570 |
|---|---|
| Medicare Enrollment ID | O20151124001989 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891186193 | NPI | - | NPPES |
| 211449002 | Medicaid | AR | |
| 176772001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MC-3081 (Arkansas) | Primary |
| Provider Name | Nicole M Scally |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760521777 PECOS PAC ID: 9234286519 Enrollment ID: I20090403000104 |
| Provider Name | Rebecca Marie Padley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710229059 PECOS PAC ID: 7911218862 Enrollment ID: I20160628001254 |
| Provider Name | Michelle Elizabeth Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447603808 PECOS PAC ID: 9638464563 Enrollment ID: I20160817000666 |
| Provider Name | Sharon H Shin |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528432390 PECOS PAC ID: 9830460369 Enrollment ID: I20170802001236 |
| Provider Name | Abigail D Johnson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1679710768 PECOS PAC ID: 8325188279 Enrollment ID: I20220601000281 |
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