RICKEY EDNA MACK (NPI# 1528560513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528560513 |
| Entity Type | Individual |
| Full Name | RICKEY EDNA MACK |
| Credential | CNP |
| Practice Address |
120 Adcock Rd Ste D Hot Springs AR 71913-7958 |
| Mailing Address |
1661 Airport Rd Ste D Hot Springs AR 71913-8184 |
| Practice Telephone | 5015475961 |
| Practice Fax Number | 5016514296 |
| Mailing Telephone | 5016257500 |
| Mailing Fax Number | 5016257777 |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2018-03-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
A005560 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
120 ADCOCK RD STE D |
| City | HOT SPRINGS |
| State | AR |
| Zip Code | 71913-7958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104213289 | Amy Leigh Henson | Nurse Practitioner | 120 Adcock Rd Ste D, Hot Springs, AR 71913-7958 | 2015-04-16 |
| 1023535952 | Jennifer Mace | Nurse Practitioner | 120 Adcock Rd Ste D, Hot Springs, AR 71913-7958 | 2017-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548722028 | Stephen L Bodemann M.d. Ltd | Internal Medicine | 1636 Higdon Ferry Road, Hot Springs, AR 71913 | 2019-04-03 |
| 1164986600 | Whitley Bryant | Behavior Technician | 219 Rockwell St, Hot Springs, AR 71913 | 2019-01-29 |
| 1841760436 | Lauren Danielle Bolding | Occupational Therapist | 4328 Central Ave Suite M, Hot Springs, AR 71913 | 2018-11-27 |
| 1164906673 | Rebecca Lynne Cleveland | Occupational Therapy Assistant | 181 Cornerstone, Hot Springs, AR 71913 | 2018-09-20 |
| 1689160293 | American Oncology Partners, P.a. | Internal Medicine | 1455 Higdon Ferry Rd Ste B, Hot Springs, AR 71913 | 2018-07-06 |
| 1932694692 | Healthstar Physicians of Hot Springs, Pllc | Radiology | 120 Adcock Rd Ste B, Hot Springs, AR 71913 | 2018-06-26 |
| 1043708001 | Statco-palmer, Inc | Audiologist | 4501 Central Avenue, Suite 174, C-6, Hot Springs, AR 71913 | 2018-04-25 |
| 1083133532 | Laken Nicolle Baldwin | Physical Therapist | 1635 Higdon Ferry Road, Ste G, Hot Springs, AR 71913 | 2017-09-15 |
| 1316463730 | Arkansas Home Care Assistance, LLC | In Home Supportive Care | 3955 Central Ave Ste 4, Hot Springs National Park, AR 71913 | 2017-08-17 |
| 1336675701 | Joni Westbrook | Case Manager/Care Coordinator | 154 Cornerstone, Hot Springs, AR 71913 | 2017-05-04 |
| Find all providers in zip 71913 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811326861 | Christina Marie Gillenwater | Nurse Practitioner | 3604 Central Ave Ste 2, Hot Springs, AR 71913-6403 | 2013-11-09 |
| 1962409334 | Lisa D Harvey | Nurse Practitioner | 4419 N Highway 7, Hot Springs, AR 71909-9301 | 2005-06-30 |
| 1851947832 | Brandee Michelle Munn | Nurse Practitioner | 4332 Central Ave, Hot Springs, AR 71913-7437 | 2019-08-14 |
| 1568948875 | Ashley Pendergraft | Nurse Practitioner | 130 Medical Park Pl, Hot Springs, AR 71901-8051 | 2018-07-19 |
| 1023535952 | Jennifer Mace | Nurse Practitioner | 120 Adcock Rd Ste D, Hot Springs, AR 71913-7958 | 2017-08-22 |
| 1437679164 | Kayla M Harrington | Nurse Practitioner | 1662 Higdon Ferry Rd Ste 140, Hot Springs, AR 71913-6980 | 2017-06-23 |
| 1124575147 | Christopher Jarvis | Nurse Practitioner | 1 Mercy Ln Ste 304, Hot Springs, AR 71913-6440 | 2016-09-07 |
| 1528309986 | Jessica C. Jones | Nurse Practitioner | 1 Mercy Ln, Suite 401, Hot Springs, AR 71913-6442 | 2013-03-11 |
| 1679583918 | Molly O Hollingsworth | Nurse Practitioner | 3633 Central Ave, Suite D, Hot Springs, AR 71913-6404 | 2006-08-09 |
| 1598775843 | Mitzi G Pruitt | Nurse Practitioner | 1629 Airport Rd, Suite B, Hot Springs, AR 71913-7951 | 2006-08-09 |
| Find all providers in HOT SPRINGS | ||||
| City | HOT SPRINGS |
| Zip Code | 71913 |
Please comment or provide details below to improve the information on RICKEY EDNA MACK.
| 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.