Karen Canulla, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

E-12245 Issued in AR

Practice address

1101 Jackson St SW
Gravette, AR 72736-9121

Phone

(479) 787-5291

Fax

(479) 344-6865

NPI assigned

Jun 19, 2007

Last updated

Jul 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

PsychiatryAlso: Addiction Medicine

Education

University of Arkansas College of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pure Balance of Nwa PLLCGroup PAC ID 6901344928, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pure Balance of Nwa PLLC

  • Psychiatry Physician
  • Rogers, AR
  • NPI 1073359931
  Medicare reassignment Care Compare group NPD
• Sgoh Acquisition Inc

  dba Ozarks Community Hospital of Gravette

  • Critical Access Hospital
  • Gravette, AR
  • NPI 1568643005
  Medicare reassignment
• Arizona Hernia and Surgical Associates, LLC

  • Surgery Physician
  • Litchfield Park, AZ
  • NPI 1932458643
  NPD
• Haven Arizona, LLC

  • Substance Abuse Rehabilitation Facility
  • Green Valley, AZ
  • NPI 1487436796
  NPD (past)

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1477758530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 JACKSON ST SW",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369121",
            "telephone_number": "479-787-5291",
            "fax_number": "479-344-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 JACKSON ST SW",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369121",
            "telephone_number": "479-787-5291",
            "fax_number": "479-344-6865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2728 N 24th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850081050",
            "country_code": "US",
            "telephone_number": "623-584-4882",
            "fax_number": "623-584-6732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANULLA",
        "first_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "36948",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "E-12245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Drugs Inc (Austin Drugs)
• Bailey Health Center, LLC (Health Builders)
• Eric Shawn Bailey, DC
• Pennie Berry, MS, LPC, LMFT
• Bailey Boatright, MS, CCC-SLP
• Zia Chang
• Carla Sawatski Cheek
• City of Gravette (Gravette Fire and Ambulance)
• Joy Ann Coonfield, LM, CPM
• Daniel Hunt Cooper, MD

• Psychiatry Physician in Gravette, AR
• Providers in Gravette, AR by specialty
• Psychiatry Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.