Mountain Home Psychiatric Medicine, PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MOUNTAIN HOME PSYCHIATRIC MEDICINE, PA

Practice address

204 N College St
Mountain Home, AR 72653-3654

Phone

(870) 424-4804

Fax

(870) 424-8651

NPI assigned

Oct 7, 2008

Organization subpart

No

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

Authorized official

Name

Annette S Walden

Title

Office Manager

Phone

(870) 424-4804

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philip W Brown, PHD

  • Psychologist
  • Mountain Home, AR
  • NPI 1861639940
  Medicare reassignment Care Compare group NPD
• Amy Elizabeth Hickman, APRN-CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Mountain Home, AR
  • NPI 1902683980
  Medicare reassignment Care Compare group NPD
• Audrey Sadler, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Mountain Home, AR
  • NPI 1083504088

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Thomas E Walden, MD

  • Psychiatry Physician
  • Mountain Home, AR
  • NPI 1508897307
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1962653063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 387",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726540387",
            "telephone_number": "870-424-4804",
            "fax_number": "870-424-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N COLLEGE ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533654",
            "telephone_number": "870-424-4804",
            "fax_number": "870-424-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HOME PSYCHIATRIC MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "WALDEN",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-424-4804"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Morton, RN
• Mountain Home Al Opco LLC
• Mountain Home Christian Clinic, Inc
• Mountain Home Family Chiropractic
• Mountain Home Nephrology and Pulmonology Clinic
• Mountain Home Radiology Consultants
• Mountain Home School District
• Mountain Home SNF Opco LLC
• Mountain Home Surgery Center
• Mountain Home Surgery Center, Inc.

• Psychiatry Physician in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Psychiatry Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.