Advanced Healing Solutions Ar

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

ADVANCED HEALING SOLUTIONS AR

Doing business as

Restorative Mobile Wound Care of SW Arkansas

Practice address

132 Gore RC
Horatio, AR 71842

Phone

(903) 215-8039

Fax

(903) 213-9047

NPI assigned

Sep 24, 2024

Last updated

Sep 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stacey D Ervin, ARNPNPI 1487697538

Title

Owner

Phone

(903) 908-0352

Specialties & licenses 1

Addresses

Other names 1

• Restorative Mobile Wound Care of SW Arkansas Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stacey D Ervin, FNP

  • Nurse Practitioner
  • Longview, TX
  • NPI 1487697538
  Authorized official Same address or phone

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1396562914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 UTAH ST",
            "city": "AVERY",
            "state": "TX",
            "postal_code": "755542600",
            "telephone_number": "903-908-0352",
            "fax_number": "903-213-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 GORE RC",
            "city": "HORATIO",
            "state": "AR",
            "postal_code": "71842",
            "telephone_number": "903-215-8039",
            "fax_number": "903-213-9047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALING SOLUTIONS AR",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-908-0352",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restorative Mobile Wound Care of SW Arkansas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Living Hope
• Kaylee Mackenzie Murry, COTA
• Brandy R Pulliam, MHPP
• Kristy Lynn Randall, PTA
• Shaleko Rae Shelton, M.S. CCC,SLP

• Medical Specialty Clinic/Center in Horatio, AR
• Providers in Horatio, AR by specialty
• Medical Specialty Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.