| Core Med PLLC | |
|
902b S Walton Blvd Ste 18 Bentonville AR 72712-5770 | |
| (479) 876-8628 | |
| (479) 876-8643 |
| Full Name | Core Med PLLC |
|---|---|
| Speciality | General Practice |
| Location | 902b S Walton Blvd Ste 18, Bentonville, Arkansas |
| Authorized Official Name and Position | Ryan Hasenclever (OWNER) |
| Authorized Official Contact | 4798768628 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Core Med PLLC 902b S Walton Blvd Ste 18 Bentonville AR 72712-5770 Ph: (479) 876-8628 | Core Med PLLC 902b S Walton Blvd Ste 18 Bentonville AR 72712-5770 Ph: (479) 876-8628 |
| NPI Number | 1295590453 |
|---|---|
| Provider Enumeration Date | 02/16/2024 |
| Last Update Date | 05/23/2025 |
| Certification Date | 05/23/2025 |
| Medicare PECOS PAC ID | 5294226460 |
|---|---|
| Medicare Enrollment ID | O20251114003529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295590453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Ryan Dale Hasenclever |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1922111897 PECOS PAC ID: 5799677472 Enrollment ID: I20080304000807 |
| Provider Name | Brandi Elana Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619681285 PECOS PAC ID: 4880069137 Enrollment ID: I20230419000434 |
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