Mena Spine & Rehab, PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1573 Issued in AR

Legal business name

MENA SPINE & REHAB, PA

Practice address

701 Morrow St S
Mena, AR 71953-4697

Phone

(479) 437-4444

Fax

(479) 437-3361

NPI assigned

Apr 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kervin T. Putman, DC

Title

Owner

Phone

(479) 437-4444

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1013972629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 833",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719530833",
            "telephone_number": "479-437-4444",
            "fax_number": "479-437-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MORROW ST S",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534697",
            "telephone_number": "479-437-4444",
            "fax_number": "479-437-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENA SPINE & REHAB, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "PUTMAN",
        "authorized_official_first_name": "KERVIN",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-437-4444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159192718",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mena Medical Center Hospice, LLC
• Mena Pediatric Center, PLLC
• Mena Public Schools
• Mena Regional Health System Pharmacy
• Mena SNF Operations LLC
• Mena Surgical Clinic
• John D Mesko, M.D.
• John-Mark Meulman, LPC
• Alina Mielnick, MD
• Sandy Morgan, APRN

• Chiropractor in Mena, AR
• Providers in Mena, AR by specialty
• Chiropractor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.