Individual provider Active NPI

Ezechiel R. Nehus, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Russellville, AR
National Provider Identifier
1912973306
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
E4337 Issued in AR
Practice address
200 N Quanah Ave
Russellville, AR 72801-2762
Phone
(479) 890-0368
Fax
(479) 890-7368
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X E4337 AR Primary

Addresses

Primary practice location

200 N Quanah Ave
Russellville, AR 72801-2762

Mailing address

200 N Quanah Ave
Russellville, AR 72801-2762
Phone (479) 890-0368

Other identifiers 2

IdentifierTypeStateIssuer
5N221OtherARARKANSAS BCBS
156412001MedicaidAR

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
I20050707000362 AR Practitioner - Otolaryngology 1052357498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Arkansas College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1808 W Main
Russellville, AR 72801-2724
Phone (479) 890-0368

Hospital & facility affiliations

  • Johnson Regional Medical Center Hospital, Clarksville, AR, CCN 040002
  • St Marys Regional Medical Center Hospital, Russellville, AR, CCN 040041

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E4337ARMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ezechiel R. Nehus, MD, PA Otolaryngology/Facial Plastic Surgery CurrentSince Apr 1, 2005 Accepting new patients

Locations

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

200 N Quanah Ave
Russellville, AR 72801
Phone (479) 890-0368

Interoperability endpoints

  • Direct secure messaging: enehus@rvent.gwaydirect.com
  • Direct secure messaging: enehusmd@rvent.gwaydirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1912973306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N QUANAH AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012762",
            "telephone_number": "479-890-0368",
            "fax_number": "479-890-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N QUANAH AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012762",
            "telephone_number": "479-890-0368",
            "fax_number": "479-890-7368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEHUS",
        "first_name": "EZECHIEL",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "AR",
            "license": "E4337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BCBS",
            "identifier": "5N221",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156412001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.