Mina Michael LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MINA MICHAEL LLC

Practice address

1355 Dave Ward Dr Ste 102
Conway, AR 72034-7082

Phone

(346) 907-4805

NPI assigned

Oct 16, 2023

Last updated

May 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mina Michael Kamel Michael, MDNPI 1124687157

Title

Owner of Entity

Phone

(346) 907-4805

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mina Michael Kamel Michael

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1124687157
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1912789835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242198",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722230021",
            "telephone_number": "346-907-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 DAVE WARD DR STE 102",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347082",
            "telephone_number": "346-907-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINA MICHAEL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "MINA",
        "authorized_official_middle_name": "MICHAEL KAMEL",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "346-907-4805",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lexi Nicole Miller
• Natalie Miller
• Rico Miller, RECOVERY ASSISTANT
• Beth Ann Milligan, PT
• Tracy L Mills, MS, LAC, CRC
• Mindful Psychiatry
• Madeline Nicole Mink
• Felicia Miranda
• Brittany Mire, QBHP
• Airrie Mitchell, RECOVERY ASSISTANT

• Internal Medicine Physician in Conway, AR
• Providers in Conway, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.