Individual provider Active NPI

Meaghan McNulty, MD

  • Internal Medicine Physician
  • Rogers, AR
National Provider Identifier
1366449423
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E12539 Issued in AR
Practice address
2710 S Rife Medical LN
Rogers, AR 72758
Phone
(479) 636-0200
Fax
(479) 986-3448
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME84895 FL
Internal Medicine Physician 207R00000X ME84895 FL
Internal Medicine Physician 207R00000X E12539 AR Primary

Addresses

Primary practice location

2710 S Rife Medical LN
Rogers, AR 72758

Mailing address

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 636-0200

Other practice location 1

3848 Fau Blvd
Suite 305
Boca Raton, FL 33431-6437
Phone (561) 455-3627

Other practice location 2

3848 Fau Blvd
Suite 305
Boca Raton, FL 33431-6437
Phone (561) 455-3627

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080521000372 FL Practitioner - Internal Medicine 6901845494

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1320 S Dixie Hwy
Coral Gables, FL 33146

15 Grumman Rd W
Bethpage, NY 11714-5029

650 5TH St
Suite 405
San Francisco, CA 94107-1521

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Affiliated Practice Organization Family Medicine Past Accepting new patients
Baystate Medical Practices, Inc Internal Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1366449423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 S RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-636-0200",
            "fax_number": "479-986-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 S RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-636-0200",
            "fax_number": "479-986-3448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3848 Fau Blvd",
            "address_2": "Suite 305",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334316437",
            "country_code": "US",
            "telephone_number": "561-455-3627",
            "fax_number": "561-393-7312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3848 Fau Blvd",
            "address_2": "Suite 305",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334316437",
            "country_code": "US",
            "telephone_number": "561-455-3627",
            "fax_number": "561-393-7312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "MEAGHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME84895",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME84895",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E12539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.