Individual provider Active NPI

Victor Stewart McNerney, DO

  • Psychiatry Physician
  • Jonesboro, AR
National Provider Identifier
1174745392
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
E-5519 Issued in AR
Practice address
615 E Matthews Ave
Jonesboro, AR 72401-3145
Phone
(870) 930-9090
Fax
(870) 931-4581
NPI assigned
May 3, 2007
Last updated
Jul 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X E-5519 AR Primary

Addresses

Primary practice location

615 E Matthews Ave
Jonesboro, AR 72401-3145

Mailing address

4413 Clubhouse Dr
Jonesboro, AR 72401-8034

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080520000398 AR Practitioner - Psychiatry 8426127218 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Bernards Hospital Inc.Group PAC ID 0941105480, 187 clinicians

Practice addresses (Care Compare)

2712 E Johnson Ave
Jonesboro, AR 72405-1874
Phone (870) 972-4100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Bernards Hospital, Inc Current Accepting new patients
St Bernards Hospital Inc Past Accepting new patients

Locations

225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

2712 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 268-4107

2712 E Johnson Ave
#3393
Jonesboro, AR 72405
Phone (870) 932-2800

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1174745392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4413 CLUBHOUSE DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724018034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013145",
            "telephone_number": "870-930-9090",
            "fax_number": "870-931-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNERNEY",
        "first_name": "VICTOR",
        "middle_name": "STEWART",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "E-5519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.