Open Door Health and Community Services

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AOO1150 Issued in AR

Legal business name

OPEN DOOR HEALTH AND COMMUNITY SERVICES

Practice address

425 N Centennial Ave
Suite a
West Fork, AR 72774-2708

Phone

(479) 294-6151

Fax

(479) 294-6152

NPI assigned

Jan 7, 2014

Organization subpart

No

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

Authorized official

Name

Lela R. Shipman, APRN

Title

Executive Director

Phone

(479) 294-6151

Specialties & licenses 1

Addresses

Tax ID family

Open Door Health and Community Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Open Door Health and Community Services

  • Family Nurse Practitioner
  • West Fork, AR
  • NPI 1063871044
  NPD tax ID

Locations

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1366864530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N CENTENNIAL AVE STE A",
            "city": "WEST FORK",
            "state": "AR",
            "postal_code": "727742708",
            "telephone_number": "479-294-6151",
            "fax_number": "479-294-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N CENTENNIAL AVE",
            "address_2": "SUITE A",
            "city": "WEST FORK",
            "state": "AR",
            "postal_code": "727742708",
            "telephone_number": "479-294-6151",
            "fax_number": "479-294-6152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN DOOR HEALTH AND COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-07",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "SHIPMAN",
        "authorized_official_first_name": "LELA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "479-294-6151",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "AOO1150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Morgan
• Natalie Elizabeth Myers, COTA
• NH Industries, Inc
• Emmalee Grace O'Dell
• Open Door Health and Community Services
• Krystle Owen, MS CF-SLP
• Twila Owens, LCSW
• Pond Pediatric Therapy
• Laura Fawn Purcell, MPT
• Meredith Purifoy, MS CF-SLP

• All providers in West Fork, AR
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.