Mena Pediatric Center, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MENA PEDIATRIC CENTER, PLLC

Practice address

900 Highway 71 N
Mena, AR 71953-4304

Phone

(479) 394-5439

NPI assigned

Jul 24, 2018

Last updated

Jun 11, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alissa M Grant, MDNPI 1003016700

Title

Physician/Owner

Phone

(479) 394-5439

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18246/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alissa Michelle Grant, M.D.

  • Pediatrics Physician
  • Mena, AR
  • NPI 1003016700
  NPD Authorized official

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1164909081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HIGHWAY 71 N",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534304",
            "telephone_number": "479-394-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HIGHWAY 71 N",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534304",
            "telephone_number": "479-394-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENA PEDIATRIC CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-24",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "ALISSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "479-394-5439",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194837001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mena Hospital Commission (Mena Regional Health System)
• Mena Hospital Commission (Mena Regional Health System Rehab Unit)
• Mena Internal Medicine
• Mena Medical Center Home Health, LLC (Elite Home Health)
• Mena Medical Center Hospice, LLC (Elite Hospice)
• Mena Public Schools
• Mena Regional Health System Pharmacy
• Mena SNF Operations LLC (The Green House Cottages of Homewood)
• Mena Spine & Rehab, PA
• Mena Surgical Clinic

• Pediatrics Physician in Mena, AR
• Providers in Mena, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.