Donna Beallis D.O. P.a.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

E-5626 Issued in AR

Legal business name

DONNA BEALLIS D.O. P.A.

Practice address

153 E Monte Painter Dr
Fayetteville, AR 72703-4002

Phone

(479) 444-2200

Fax

(479) 444-2390

NPI assigned

Nov 16, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Donna B Beallis, D.O.

Title

Owner

Phone

(479) 806-0647

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1184951998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11134",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171134",
            "telephone_number": "479-285-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 E MONTE PAINTER DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034002",
            "telephone_number": "479-444-2200",
            "fax_number": "479-444-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNA BEALLIS D.O. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-16",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "BEALLIS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-806-0647",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AR",
            "license": "E-5626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200199440A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phillip G Doerner III, D.O.
• Cassandra Marie Dominick, LPC
• Lindy Dawn Domke
• Kayla Lashae Donald, COTA
• Daniel Mosen Dong
• Donna M Van Kirk Edd PLLC
• Janelle Lanee Douglas, PHARM. D
• Lisa Renae Douglas, MHPP
• Diedra Dourth, PHARMD
• Ashley Nicole Dover, MS, CCC/SLP

• Adult Medicine Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Adult Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.