NPIMap

Organization Active NPI

Provision Health Care LLC

  • Family Nurse Practitioner
  • El Dorado, AR
National Provider Identifier
1134090061
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PROVISION HEALTH CARE LLC
Practice address
525 W Faulkner St
El Dorado, AR 71730-4518
Phone
(870) 337-2009
NPI assigned
Sep 15, 2025
Organization subpart
Yes
Parent organization
PROVISION HEALTH CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Authorized official

Name
Jacey Meloy
Title
Practice Manager
Phone
(318) 322-9252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

525 W Faulkner St
El Dorado, AR 71730-4518

Mailing address

PO Box 510
West Monroe, LA 71294-0510
Phone (318) 322-9252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260106001581 AR Part B Supplier - Clinic/Group Practice 0345610341 Receives reassigned benefits from 2 practitioners
Practice locations: El Dorado, AR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Provision Health Care LLC2 organizations share this tax ID, including this one
Part of
Provision Health Care LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

525 W Faulkner St
El Dorado, AR 71730
Phone (870) 337-2009

2933 Cypress St
Ste 1
West Monroe, LA 71291
Phone (318) 322-3637

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1757894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1134090061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712940510",
            "telephone_number": "318-322-9252",
            "fax_number": "318-322-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W FAULKNER ST",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304518",
            "telephone_number": "870-337-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION HEALTH CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVISION HEALTH CARE LLC",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "MELOY",
        "authorized_official_first_name": "JACEY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "318-322-9252"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "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 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.