Individual provider Active NPI

Alexys Nicole Marrufo

  • Pediatrics Physician
  • Lowell, AR
National Provider Identifier
1831777374
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E-18213 Issued in AR
Practice address
325 S 6TH PL
Lowell, AR 72745-9704
Phone
(479) 636-9234
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-18213 AR Primary

Addresses

Primary practice location

325 S 6TH PL
Lowell, AR 72745-9704

Mailing address

6783 Autumn Ave
Springdale, AR 72762-4584
Phone (479) 270-2726

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240819001205 AR Practitioner - Pediatric Medicine 7517405830 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Aug 5, 2024 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Aug 5, 2024 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

325 S 6th Pl
Lowell, AR 72745
Phone (479) 636-9234

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1831777374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6783 AUTUMN AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727624584",
            "telephone_number": "479-270-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S 6TH PL",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727459704",
            "telephone_number": "479-636-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRUFO",
        "first_name": "ALEXYS",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-18213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, AR

Sources for this page

Verify at the official NPI Registry.