NPIMap

Organization Active NPI

Venvisor Health of Ar PA

  • Nurse Practitioner
  • Bentonville, AR
National Provider Identifier
1992553028
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
VENVISOR HEALTH OF AR PA
Practice address
1202 NE McClain Rd BLDG 7
Bentonville, AR 72712-3875
Phone
(203) 901-2493
Fax
(866) 497-2991
NPI assigned
May 13, 2024
Last updated
May 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
David PenryNPI 1306849922
Title
Owner
Phone
(203) 901-2493

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
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

1202 NE McClain Rd BLDG 7
Bentonville, AR 72712-3875

Mailing address

PO Box 986500
Boston, MA 02298-6500
Phone (203) 901-2493

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240624001176 AR Part B Supplier - Clinic/Group Practice 8022551647 Receives reassigned benefits from 64 practitioners
Practice locations: Bentonville, AR

National Provider Directory

National Provider Directory

Locations

1202 NE McClain Rd
Bentonville, AR 72712
Phone (479) 278-4323

Practitioners & affiliated clinicians

Practitioners 67

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1992553028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986500",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986500",
            "telephone_number": "203-901-2493",
            "fax_number": "866-497-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 NE MCCLAIN RD BLDG 7",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123875",
            "telephone_number": "203-901-2493",
            "fax_number": "866-497-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENVISOR HEALTH OF AR PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-13",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "PENRY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-901-2493"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.