Stanley Louis Reyenga, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

C4992 Issued in AR

Practice address

1311 South I St.
ER Dept.
Ft. Smith, AR 72901

Phone

(479) 441-5011

Fax

(405) 749-4561

NPI assigned

Mar 31, 2006

Last updated

Nov 12, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stan L. Reyenga Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercy Clinic Fort Smith Communities

  • Urgent Care Clinic/Center
  • Fort Smith, AR
  • NPI 1134425721
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1043271679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD",
            "address_2": "SUITE 121",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341785",
            "telephone_number": "405-751-4664",
            "fax_number": "405-749-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 SOUTH I ST.",
            "address_2": "ER DEPT.",
            "city": "FT. SMITH",
            "state": "AR",
            "postal_code": "72901",
            "telephone_number": "479-441-5011",
            "fax_number": "405-749-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYENGA",
        "first_name": "STANLEY",
        "middle_name": "LOUIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "C4992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STAN",
            "last_name": "REYENGA",
            "middle_name": "L.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Matthew C Renner, OD
• Jana Leighette Reno
• Bindu Repala, MD
• Resilient Waves Counseling LLC
• Resilient Youth Counseling LLC
• Diana Reyes Macias, APRN
• Michelle Reyes Macias, APRN-CNP
• Dinora Morales Reyes, LPC
• Dylan Reynolds
• Taylor Reynolds

• Emergency Medicine Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Emergency Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; 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.