Nicole M. Scally MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MC-3081 Issued in AR

Legal business name

NICOLE M. SCALLY MD PA

Doing business as

Northwest Arkansas Family Medicine and Obstetrics

Practice address

2000 S Promenade Blvd
Suite 202
Rogers, AR 72758-9073

Phone

(479) 282-2737

Fax

(479) 316-4072

NPI assigned

Feb 9, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Nicole Scally, MDNPI 1760521777

Title

Chairman/President/Secretary

Phone

(479) 282-2737

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Northwest Arkansas Family Medicine and Obstetrics Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 7

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

• Nicole M. Scally, MD

  • Family Medicine Physician
  • Rogers, AR
  • NPI 1760521777
  Medicare reassignment NPD Authorized official
• Lydia Flikkema

  • Advanced Practice Midwife
  • Rogers, AR
  • NPI 1821843764
  Medicare reassignment NPD
• Michelle E Gardner, APRN

  • Family Nurse Practitioner
  • Rogers, AR
  • NPI 1447603808
  Medicare reassignment NPD
• Brittany Newton Maier-Hunter, APRN

  • Family Nurse Practitioner
  • Rogers, AR
  • NPI 1245093608
  Medicare reassignment NPD
• Rebecca Marie Padley, M.D., M.B.A.

  • Family Medicine Physician
  • Fort Smith, AR
  • NPI 1710229059
  Medicare reassignment NPD
• Abigail Diane Johnson, CNM, APRN

  • Advanced Practice Midwife
  • Greenville, SC
  • NPI 1679710768

  AR

  Medicare reassignment NPD
• Tabitha Davies, DO

  • Family Medicine Physician
  • Rogers, AR
  • NPI 1174938609
  Medicare reassignment

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1891186193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S PROMENADE BLVD",
            "address_2": "SUITE 202",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589073",
            "telephone_number": "479-282-2737",
            "fax_number": "479-316-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S PROMENADE BLVD",
            "address_2": "SUITE 202",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589073",
            "telephone_number": "479-282-2737",
            "fax_number": "479-316-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE M. SCALLY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-09",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "SCALLY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CHAIRMAN/PRESIDENT/SECRETARY",
        "authorized_official_telephone_number": "479-282-2737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "MC-3081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211449002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176772001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Arkansas Family Medicine and Obstetrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim CHI Thi Nguyen
• Kimberly Nguyen
• Lauren Gwen Nguyen, APRN
• Tanner Nichols, DO
• Chantal Nicolas, NP
• Mary Nicosia, LAC
• Erika Leticia Nielsen, LPC, LMFT
• Jennifer Niles
• Lee Ann Nimmo, LPC
• Lindsay Elizabeth Nordmeyer, PA-C

• Family Medicine Physician in Rogers, AR
• Providers in Rogers, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.