NPIMap

Individual provider Active NPI

Michael E Clevenger, MD

  • Neurology Physician
  • Searcy, AR
National Provider Identifier
1245230341
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
E4264 Issued in AR
Practice address
2900 Hawkins Dr
Searcy, AR 72143-4802
Phone
(501) 278-2800
Fax
(501) 278-3073
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X J8964 TX
Neurology Physician 2084N0400X E4264 AR Primary

Addresses

Primary practice location

2900 Hawkins Dr
Searcy, AR 72143-4802

Mailing address

2900 Hawkins Dr
Searcy, AR 72143-4802
Phone (501) 278-2800

Other identifiers 2

IdentifierTypeStateIssuer
127758001MedicaidAR
047792901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091231000105 TX Practitioner - Neurology 1951357573 Reassigns benefits to 1 organization
I20180711001120 AR Practitioner - Neurology 1951357573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Oklahoma College of Medicine, 1986
Medicare assignment
May accept Medicare assignment
Group practices
White County Medical CenterGroup PAC ID 4880688654, 182 clinicians

Practice addresses (Care Compare)

2900 Hawkins Dr
Searcy, AR 72143-4802
Phone (501) 278-2800

Hospital & facility affiliations

  • White County Medical Center Hospital, Searcy, AR, CCN 040014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E4264ARMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC CurrentSince Oct 1, 2017 Accepting new patients
Collom & Carney Clinic Association Current Accepting new patients
Arkansas Health Group Current Accepting new patients
Collom & Carney Clinic Association Current Accepting new patients
White County Medical Center CurrentSince Aug 1, 2018 Accepting new patients
Collom & Carney Clinic Association Current Accepting new patients
White County Medical Center CurrentSince Aug 1, 2018 Accepting new patients

Locations

2900 Hawkins Dr
Searcy, AR 72143
Phone (501) 278-2800

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

5002 Cowhorn Creek Rd
Texarkana, TX 75503
Phone (903) 614-3008

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1245230341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 HAWKINS DR",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721434802",
            "telephone_number": "501-278-2800",
            "fax_number": "501-278-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 HAWKINS DR",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721434802",
            "telephone_number": "501-278-2800",
            "fax_number": "501-278-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVENGER",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "J8964",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AR",
            "license": "E4264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127758001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047792901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Searcy, AR

Sources for this page

Verify at the official NPI Registry.