| |
2907 E Joyce Blvd Ste 5 Fayetteville AR 72703-5390 | |
(479) 212-8492 | |
(479) 265-3890 |
Full Name | |
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Speciality | Nurse Practitioner |
Location | 2907 E Joyce Blvd Ste 5, Fayetteville, Arkansas |
Authorized Official Name and Position | Laura T Bailey (NURSE PRACTITIONER) |
Authorized Official Contact | 4797510190 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
2907 E Joyce Blvd Ste 5 Fayetteville AR 72703-5390 Ph: (479) 212-8492 | 2907 E Joyce Blvd Ste 5 Fayetteville AR 72703-5390 Ph: (479) 212-8492 |
NPI Number | 1720691678 |
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Provider Enumeration Date | 08/28/2020 |
Last Update Date | 09/06/2023 |
Medicare PECOS PAC ID | 4880008259 |
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Medicare Enrollment ID | O20210126000965 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720691678 | NPI | - | NPPES |
1891115663 | Other | AR | NPI |
195361001 | Medicaid | AR | |
203336758 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Provider Name | Laura Bailey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891115663 PECOS PAC ID: 7113147406 Enrollment ID: I20141009000216 |
Provider Name | Leah M Carrington |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629453030 PECOS PAC ID: 2062712631 Enrollment ID: I20151203002431 |
Provider Name | Brent T Rush |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184072258 PECOS PAC ID: 3779531678 Enrollment ID: I20160825000392 |
K E Management Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 E Augustine Ln Ste 7, Fayetteville, AR 72703 Phone: 479-200-9812 Fax: 866-243-7203 | |
Arcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1792 E Joyce Blvd, Fayetteville, AR 72703 Phone: 501-500-5001 Fax: 501-500-5001 | |