Mena Heart and Vascular Clinic

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

E5746 Issued in AR

Legal business name

MENA HEART AND VASCULAR CLINIC

Practice address

403 Morrow St N
Suite G
Mena, AR 71953-4324

Phone

(479) 394-6100

NPI assigned

Jun 22, 2009

Last updated

Jun 22, 2009By 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

Bob Ellzey

Title

Ceo

Phone

(479) 394-6100

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mena Hospital Commission

  dba Mena Regional Health System Rehab Unit

  • Rehabilitation Hospital Unit
  • Mena, AR
  • NPI 1902901200

  Member Of

  NPD member

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245628800000",
    "number": "1679701213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 295",
            "city": "LOCKESBURG",
            "state": "AR",
            "postal_code": "718460295",
            "telephone_number": "870-289-5865",
            "fax_number": "870-289-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 MORROW ST N",
            "address_2": "SUITE G",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534324",
            "telephone_number": "479-394-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENA HEART AND VASCULAR CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-06-22",
        "status": "A",
        "authorized_official_last_name": "ELLZEY",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "479-394-6100"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "E5746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mena Dialysis Center LLC (Mena Dialysis Center)
• Mena Eye Care
• Mena Family Health Center
• Mena General Surgical Services, L.L.C.
• Mena Health, LLC (Mena Manor)
• Mena Hospital Commission (Mena Regional Health System)
• Mena Hospital Commission (Grannis Medical Clinic)
• Mena Hospital Commission (Mena Regional Health System)
• Mena Hospital Commission (Mountain View Clinic)
• Mena Hospital Commission (Mena Regional Health System)

• Cardiovascular Disease Physician in Mena, AR
• Providers in Mena, AR by specialty
• Cardiovascular Disease Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.