NPIMap

Organization Active NPI

Mena Hospital Commission

Doing business as Mena Regional Health System Psych Unit

  • Psychiatric Hospital Unit
  • Mena, AR
National Provider Identifier
1811092117
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
AR4321 Issued in AR
Legal business name
MENA HOSPITAL COMMISSION
Doing business as
Mena Regional Health System Psych Unit
Practice address
311 N Morrow
Mena, AR 71953-2516
Phone
(479) 394-6100
Fax
(479) 394-4577
NPI assigned
Sep 13, 2006
Last updated
Mar 21, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
MENA HOSPITAL COMMISSIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Authorized official

Name
Gayla Crowley
Title
Director Revenue Cycle
Phone
(479) 243-2239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X AR4321 AR Primary

Addresses

Primary practice location

311 N Morrow
Mena, AR 71953-2516

Mailing address

311 N Morrow
Mena, AR 71953-2516
Phone (479) 394-6100

Other identifiers 1

IdentifierTypeStateIssuer
10015OtherARBLUE CROSS BLUE SHEILD

Other names 1

  • Mena Regional Health System Psych Unit Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250311003077 AR Part A Provider - Hospital 8527057678 Practice locations: Mena, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811092117. Details of each certification follow.

Hospital certification: CCN 04M334

Legal name
MENA HOSPITAL COMMISSION
Doing business as
MENA REGIONAL HEALTH SYSTEM
Organization structure
OtherNon-profit
Enrollment address
311 Morrow St N
Mena, AR 71953-2516
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Mena Hospital Commissio

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
David Gilbert Individual Corporate DirectorChairman Aug 10, 2010
City of Mena Office of City Clerk Organization, Mena, AR 5% Or Greater Direct Ownership Interest Oct 1, 2007
John Maddox Individual Corporate DirectorTreasurer Mar 16, 2021
Leon Gerald Philpot Individual Corporate DirectorSecretary Oct 18, 2007
Phillip Hensley Individual Corporate Director Aug 9, 2022
Michael Myers Individual Corporate Director Mar 8, 2016
Carlos B Rocha Individual Corporate Director Dec 17, 2007
Paul Ervin Individual Corporate DirectorCfo Jul 26, 2020
W-2 Managing Employee Jul 26, 2020
Paula Brotherton Individual Corporate DirectorVice Chairman Nov 6, 2007
Michael Wood Individual Corporate DirectorCeo Sep 4, 2023
W-2 Managing EmployeeAd; Mar 20, 2017
Gayla R Crowley Individual W-2 Managing EmployeeDirector of Revenue Cycle May 20, 2015

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458518400000",
    "number": "1811092117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N MORROW",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719532516",
            "telephone_number": "479-394-6100",
            "fax_number": "479-394-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N MORROW",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719532516",
            "telephone_number": "479-394-6100",
            "fax_number": "479-394-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENA HOSPITAL COMMISSION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MENA HOSPITAL COMMISSION",
        "enumeration_date": "2006-09-13",
        "last_updated": "2016-03-21",
        "status": "A",
        "authorized_official_last_name": "CROWLEY",
        "authorized_official_first_name": "GAYLA",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "479-243-2239"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "AR",
            "license": "AR4321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "10015",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mena Regional Health System Psych Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mena, AR

Sources for this page

Verify at the official NPI Registry.