Individual provider Active NPI

Kamra Elizabeth Mays, PH.D.

  • Clinical Psychologist
  • Bentonville, AR
National Provider Identifier
1073734919
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
07-13P Issued in AR
Practice address
1720 S Walton Blvd Ste 6
Bentonville, AR 72712-7533
Phone
(870) 939-7606
NPI assigned
May 1, 2007
Last updated
Aug 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 07-13P AR
Cognitive & Behavioral Psychologist 103TB0200X 07-13P AR
Clinical Psychologist 103TC0700X 07-13P AR Primary
Health Service Psychologist 103TH0100X 07-13P AR
Health Psychologist 103TH0004X 07-13P AR

Addresses

Primary practice location

1720 S Walton Blvd Ste 6
Bentonville, AR 72712-7533

Mailing address

1426 Water Way Dr
Cave Springs, AR 72718
Phone (870) 939-7606

Other practice location 1

1708 E Joyce Blvd Ste 3
Fayetteville, AR 72703-5251
Phone (479) 301-2565

Other practice location 2

1720 S Walton Blvd Ste 6
Bentonville, AR 72712-7533
Phone (870) 939-7606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110001120 AR Practitioner - Clinical Psychologist 4385667831 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
07-13PARMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Pain and Wellness CurrentSince May 1, 2015 Accepting new patients
Optimal Pain and Wellness CurrentSince May 1, 2015 Accepting new patients

Locations

1708 E Joyce Blvd
Ste 3
Fayetteville, AR 72703
Phone (479) 301-2565

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1073734919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 WATER WAY DR",
            "city": "CAVE SPRINGS",
            "state": "AR",
            "postal_code": "72718",
            "telephone_number": "870-939-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S WALTON BLVD STE 6",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127533",
            "telephone_number": "870-939-7606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1708 E Joyce Blvd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727035251",
            "country_code": "US",
            "telephone_number": "479-301-2565",
            "fax_number": "479-301-2717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1720 S Walton Blvd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727127533",
            "country_code": "US",
            "telephone_number": "870-939-7606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYS",
        "first_name": "KAMRA",
        "middle_name": "ELIZABETH",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "07-13P",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AR",
            "license": "07-13P",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "07-13P",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "AR",
            "license": "07-13P",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "AR",
            "license": "07-13P",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.