NPIMap

Organization Active NPI

Mkosmo, LLC

  • Family Medicine Physician
  • Fort Smith, AR
National Provider Identifier
1871106476
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MKOSMO, LLC
Practice address
9524 Wey Bridge Dr
Fort Smith, AR 72916-7007
Phone
(786) 623-8293
NPI assigned
Aug 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Malik ShahidNPI 1649539768
Title
Owner
Phone
(786) 623-8293

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

9524 Wey Bridge Dr
Fort Smith, AR 72916-7007

Mailing address

9524 Wey Bridge Dr
Fort Smith, AR 72916-7007

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1871106476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9524 WEY BRIDGE DR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729167007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9524 WEY BRIDGE DR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729167007",
            "telephone_number": "786-623-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MKOSMO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "SHAHID",
        "authorized_official_first_name": "MALIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-623-8293"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.