NPIMap

Organization Active NPI

El Dorado Wellness Center LLC

  • Cardiovascular Disease Physician
  • El Dorado, AR
National Provider Identifier
1033587720
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
EL DORADO WELLNESS CENTER LLC
Practice address
431 Thompson Ave
Suite B
El Dorado, AR 71730-4553
Phone
(870) 864-9962
NPI assigned
Sep 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Authorized official

Name
Veronica Segreto
Title
Owner
Phone
(870) 864-9962

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

431 Thompson Ave
Suite B
El Dorado, AR 71730-4553

Mailing address

431 Thompson Ave
Suite B
El Dorado, AR 71730-4553
Phone (870) 864-9962

National Provider Directory

National Provider Directory

Locations

431 Thompson Ave
Ste B
El Dorado, AR 71730
Phone (870) 639-8128

NPI Registry JSON

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1033587720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 THOMPSON AVE",
            "address_2": "SUITE B",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304553",
            "telephone_number": "870-864-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 THOMPSON AVE",
            "address_2": "SUITE B",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304553",
            "telephone_number": "870-864-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL DORADO WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "SEGRETO",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-864-9962"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.