Active NPI
Brian D Mahana
- Family Nurse Practitioner
- Fayetteville, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A004167
- Practice address
- 3211 N. North Hills Blvd.
Suite 110
Fayetteville, AR 72703 - Phone
- (479) 571-4338
- Fax
- (479) 571-4015
- NPI assigned
- Aug 21, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A004167 | AR | Primary |
Addresses
Primary practice location
3211 N. North Hills Blvd.
Suite 110
Fayetteville, AR 72703
Mailing address
PO Box 655
Lowell, AR 72745-0655
Phone (479) 463-7775
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3211 N N Hills Blvd
Suite 110
Fayetteville, AR 72703-5602
Phone (479) 571-4338
Hospital & facility affiliations
- Washington Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington Regional Medical System | Current | Accepting new patients | |
| Washington Regional Medical System | Current | Accepting new patients | |
| Washington Regional Medical System | Past | Accepting new patients |
Locations
3211 N Northhills Blvd
Ste 110
Fayetteville, AR 72703
Phone (479) 571-4338
3344 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 582-7213
Interoperability endpoints
- bmahana34528@washingtonregional.direct-ci.com
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.
-
- Interventional Cardiology Physician
- Fayetteville, AR
- NPI 1679890966
-
- Family Medicine Physician
- Farmington, AR
- NPI 1275839011
-
- Hospitalist Physician
- Fayetteville, AR
- NPI 1306801485
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fayetteville, AR
- NPI 1083609150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518739200000",
"number": "1902205248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 655",
"city": "LOWELL",
"state": "AR",
"postal_code": "727450655",
"telephone_number": "479-463-7775",
"fax_number": "479-463-7187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3211 N. NORTH HILLS BLVD.",
"address_2": "SUITE 110",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "72703",
"telephone_number": "479-571-4338",
"fax_number": "479-571-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHANA",
"first_name": "BRIAN",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-21",
"last_updated": "2018-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A004167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.