MOUNTAIN-HOME MEDICAL GROUP, PA (NPI# 1225087398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225087398 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN-HOME MEDICAL GROUP, PA |
| Other Organization Name | MTN HOME MEDICAL GROUP PA |
| Practice Address |
353 East 8th Street Mountain Home AR 72653 |
| Mailing Address |
Po Box 1836 Mountain Home AR 72654-1836 |
| Practice Telephone | 8704253125 |
| Practice Fax Number | 8704245059 |
| Mailing Telephone | 8704253125 |
| Mailing Fax Number | 8704245059 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2011-04-14 |
| Authorized Official Name | MRS. MAXWELL G CHENEY (OWNER) |
| Authorized Official Telephone | 8704253125 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | MC0049 | AR | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | MC0049 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 101002002 | 05 |
| Other Name | Type Code |
|---|---|
| Mtn Home Medical Group PA | Other Name - Individual/Organization |
| Street Address |
353 EAST 8TH STREET |
| City | MOUNTAIN HOME |
| State | AR |
| Zip Code | 72653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513934 | Maranda Hickman | Physical Therapy Assistant | 347 Hwy 62 East College Plaza, Mountain Home, AR 72653 | 2019-11-21 |
| 1659929156 | Gale E Bacan | Technician | 1703 Monroe Ave, Mountain Home, AR 72653 | 2019-08-28 |
| 1891259321 | Kidspiration Pediatric Therapy Services | Clinic/Center | 710 Bradley Dr., Mountain Home, AR 72653 | 2019-01-29 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| 1346769155 | Heather Bollinger | Nurse Practitioner | 65 Walmart Drive, C/o Clinic At Walmart, Mountain Home, AR 72653 | 2017-09-12 |
| 1447774989 | Natalie D Ahrent | Physical Medicine & Rehabilitation | 804 Coley Dr, Mountain Home, AR 72653 | 2017-07-26 |
| 1417486028 | Andrew David Hatman | Case Manager/Care Coordinator | 1349 Hampshire Circle, Mountain Home, AR 72653 | 2017-06-07 |
| 1568848315 | Taylor Chiropractic Plc | Health Maintenance Organization | 103 S Main St Ste 5, Mountain Home, AR 72653 | 2015-08-04 |
| 1942606306 | Harps Food Stores, Inc | Pharmacy | 2089 Highway 62 West, Mountain Home, AR 72653 | 2014-11-13 |
| 1972920726 | Lavonne Armstrong | Counselor | 8 Medical Plaza, Mountain Home, AR 72653 | 2014-03-18 |
| Find all providers in zip 72653 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497924047 | Barbara Tan King Overbay | Internal Medicine | Vamc 11-pc, Primary Care Clinic, Mountain Home, TN 37684 | 2008-02-28 |
| 1689898843 | Grant Mathews | Internal Medicine | 555 West 6th St, Mountain Home, AR 72653-3207 | 2007-04-12 |
| 1073692166 | Krzysztof Hendryk Ziola | Internal Medicine | 2280 American Legion Blvd., Mountain Home, ID 83647 | 2006-11-02 |
| 1952482440 | Michael Peter Koelsch | Internal Medicine | 805 North 6th East, Mountain Home, ID 83647 | 2006-10-18 |
| 1073600011 | William Dralle | Internal Medicine | Corner of Lamont and Sidney Streets, Mountain Home, TN 37684 | 2006-10-10 |
| 1821009473 | Carol Procter | Internal Medicine | Corner of Lamont and Sidney, Mountain Home, TN 37684 | 2006-08-10 |
| 1407888571 | Jonathan Lee Pollitte | Internal Medicine | James H Quillen Veterans Affairs Medical Center, Sydney and Lamont Street, Mountain Home, TN 37684 | 2006-07-07 |
| 1760429740 | Paul Thomas Provance | Internal Medicine | James H Quillen Va Medical Center, Mountain Home, TN 37684-4000 | 2006-05-31 |
| 1013961994 | James C Croom | Internal Medicine | 230 Highway 5 N Ste 20, Mountain Home, AR 72653-3031 | 2006-05-22 |
| 1649236290 | Lance R Lincoln | Internal Medicine | 405 Buttercup Dr, Mountain Home, AR 72653-2910 | 2006-04-24 |
| Find all providers in MOUNTAIN HOME | ||||
| City | MOUNTAIN HOME |
| Zip Code | 72653 |
Please comment or provide details below to improve the information on MOUNTAIN-HOME MEDICAL GROUP, PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.