Organization Active NPI

Savanna Cloer McCain PHD, PA

  • Clinical Psychologist
  • Fayetteville, AR
National Provider Identifier
1922470020
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
00-11P Issued in AR
Legal business name
SAVANNA CLOER MCCAIN PHD, PA
Practice address
4257 N Gabel Dr # 2B
Fayetteville, AR 72703-5004
Phone
(479) 856-6688
Fax
(479) 856-6696
NPI assigned
Oct 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Authorized official

Name
Dr. Savanna Cloer McCain, PHDNPI 1386676583
Title
Psychologist
Phone
(479) 856-6688

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 00-11P AR Primary

Addresses

Primary practice location

4257 N Gabel Dr # 2B
Fayetteville, AR 72703-5004

Mailing address

4257 N Gabel Dr # 2B
Fayetteville, AR 72703-5004
Phone (479) 856-6688

Other identifiers 1

IdentifierTypeStateIssuer
142830019MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160509000773 AR Part B Supplier - Clinic/Group Practice 4789983024 Receives reassigned benefits from 1 practitioner
Practice locations: Springdale, AR

National Provider Directory

National Provider Directory

Locations

4257 N Gabel Dr
Ste 2B
Fayetteville, AR 72703
Phone (479) 738-7059

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": "1445990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1922470020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4257 N GABEL DR # 2B",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035004",
            "telephone_number": "479-856-6688",
            "fax_number": "479-856-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4257 N GABEL DR # 2B",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035004",
            "telephone_number": "479-856-6688",
            "fax_number": "479-856-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAVANNA CLOER MCCAIN PHD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "MCCAIN",
        "authorized_official_first_name": "SAVANNA",
        "authorized_official_middle_name": "CLOER",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "479-856-6688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "00-11P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142830019",
            "state": "AR"
        }
    ],
    "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 Oct 28, 2015; 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.