Apex Medical LLC
Organization Active NPI General Practice Physician · Mena, AR
NPI 1306641550 · NPPES record last updated Feb 13, 2025
Key facts
- NPI
- 1306641550
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- APEX MEDICAL LLC
- Practice address
- 403 Morrow St N
Mena, AR 71953-4324 - Phone
- (918) 720-4957
- NPI assigned
- Feb 13, 2025
- Organization subpart
- Yes
- Parent organization (as reported)
- APEX MEDICAL LLC
Authorized official
- Name
- Mr. Donald R Brown Jr.
- Title
- President/Ceo
- Phone
- (918) 720-4957
Practitioners 1
-
Stephanie Rostollan, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D2319161 | Rostollan Family Practice, Aesthetics & Wellness | Certificate of waiver | Feb 24, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250701004850 | AR | Part B Supplier - Clinic/Group Practice | 2365955481 |
Receives reassigned benefits from 1 practitioner Practice locations: Mena, AR |
National Provider Directory
- Part of
- Apex Medical LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
403 Morrow St N
Mena, AR 71953-4324
Mailing address
4312 S Retana Ave
Broken Arrow, OK 74011-1397
Phone (918) 720-4957
Other names
- Rostollan Family Practce, Aesthetics, and Wellness
- Rostollan Family Practice, Aesthetics, and Wellness
Other providers in Mena, AR
- Mary Kay Alexandar
- Alina Mielnick, MD, PA
- American Oncology Partners, P.a.
- American Oncology Partners, P.a.
- Jessica Elizabeth Anderson
- Area Agency on Aging of Western Arkansas, Inc
- Area Agency on Aging of Western Arkansas, Inc
- Arhealth First Family Clinic PLLC
- Arkansas Liver and Gastroenterology, P.a.
- Arkansas Pain Therapy Mena Clinic LLC
All providers in Mena, AR · General Practice Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.