NPIMap

Organization Active NPI

Healthy Connections Specialty, LLC

  • General Practice Physician
  • Mena, AR
National Provider Identifier
1245774041
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
HEALTHY CONNECTIONS SPECIALTY, LLC
Practice address
136 Health Park Dr
Mena, AR 71953-9072
Phone
(479) 437-3449
Fax
(479) 437-3708
NPI assigned
Dec 13, 2016
Last updated
May 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Authorized official

Name
Shana Bush
Title
Credentialing Specialist
Phone
(479) 437-3449

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU
General Practice Physician 208D00000X NU Primary
Podiatrist 213E00000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU
Physical Therapist 225100000X NU

Addresses

Primary practice location

136 Health Park Dr
Mena, AR 71953-9072

Mailing address

PO Box 1848
Mena, AR 71953-1841
Phone (479) 437-3449

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1245774041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719531841",
            "telephone_number": "479-437-3449",
            "fax_number": "479-243-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 HEALTH PARK DR",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719539072",
            "telephone_number": "479-437-3449",
            "fax_number": "479-437-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY CONNECTIONS SPECIALTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "SHANA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "479-437-3449"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mena, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.