NPIMap

Organization Active NPI

Mountain Home Nephrology and Pulmonology Clinic

  • Pulmonary Disease Physician
  • Mountain Home, AR
National Provider Identifier
1992083588
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
E-5121 Issued in AR
Legal business name
MOUNTAIN HOME NEPHROLOGY AND PULMONOLOGY CLINIC
Practice address
555 W 6TH St
Mountain Home, AR 72653-3409
Phone
(870) 425-1787
Fax
(870) 425-2009
NPI assigned
Jul 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Dr. Sara Rebecca Martin, M.D.
Title
Physician
Phone
(501) 786-0802

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X E-5121 AR
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X E-5332 AR
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X E-5121 AR Primary

Addresses

Primary practice location

555 W 6TH St
Mountain Home, AR 72653-3409

Mailing address

555 W 6TH St
Mountain Home, AR 72653-3409
Phone (870) 425-1787

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1992083588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W 6TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533409",
            "telephone_number": "870-425-1787",
            "fax_number": "870-425-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W 6TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533409",
            "telephone_number": "870-425-1787",
            "fax_number": "870-425-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HOME NEPHROLOGY AND PULMONOLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-29",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "REBECCA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "501-786-0802",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AR",
            "license": "E-5121",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "AR",
            "license": "E-5332",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AR",
            "license": "E-5121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.