Active NPI
Healthy Connections Specialty, LLC
- Podiatrist
- Malvern, AR
National Provider Identifier
1962003210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- HEALTHY CONNECTIONS SPECIALTY, LLC
- Practice address
- 900 Martin Luther King Blvd Ste 200
Malvern, AR 72104-2217 - Phone
- (888) 710-8220
- Fax
- (866) 573-0761
- NPI assigned
- Nov 3, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shana Bush
- Title
- Credentialing Specialist
- Phone
- (479) 437-3449
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | |||
| Cardiovascular Disease Physician | 207RC0000X | |||
| Interventional Cardiology Physician | 207RI0011X | |||
| Podiatrist | 213E00000X | Primary |
Addresses
Primary practice location
900 Martin Luther King Blvd Ste 200
Malvern, AR 72104-2217
Mailing address
PO Box 1848
Mena, AR 71953-1841
National Provider Directory
National Provider DirectoryLocations
900 Martin Luther King Blvd
Ste 108
Malvern, AR 72104
Phone (501) 332-7525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604361600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1682035200000",
"number": "1962003210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1848",
"city": "MENA",
"state": "AR",
"postal_code": "719531841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 MARTIN LUTHER KING BLVD STE 200",
"city": "MALVERN",
"state": "AR",
"postal_code": "721042217",
"telephone_number": "888-710-8220",
"fax_number": "866-573-0761"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTHY CONNECTIONS SPECIALTY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-11-03",
"last_updated": "2023-04-21",
"certification_date": "2023-04-21",
"status": "A",
"authorized_official_last_name": "BUSH",
"authorized_official_first_name": "SHANA",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "479-437-3449"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Interventional Cardiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Malvern, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.