Ella Beth Durham, CPO, C.PED
Individual provider Active NPI Prosthetist · Searcy, AR
NPI 1215097050 · NPPES record last updated Feb 18, 2015
Key facts
- NPI
- 1215097050
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prosthetist 224P00000X
- Practice address
- 2930 E Moore Ave
Searcy, AR 72143-4831 - Phone
- (501) 368-0868
- Fax
- (501) 368-0003
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Prosthetic Services, Inc. | Orthotist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | |||
| Prosthetist | 224P00000X | Yes |
Addresses
Primary practice location
2930 E Moore Ave
Searcy, AR 72143-4831
Mailing address
2930 E Moore Ave
Searcy, AR 72143-4831
Phone (501) 368-0868
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 457554716 | Medicaid | AR |
Other providers in Searcy, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.