| Vitality Plus | |
|
501 Hospital Dr Mountain Home AR 72653-2912 | |
| (870) 580-0283 | |
| (870) 580-0297 |
| Full Name | Vitality Plus |
|---|---|
| Speciality | Clinic/Center |
| Location | 501 Hospital Dr, Mountain Home, Arkansas |
| Authorized Official Name and Position | Daniel B Decker (OWNER) |
| Authorized Official Contact | 8702325215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality Plus 501 Hospital Dr Mountain Home AR 72653-2912 Ph: (870) 580-0283 | Vitality Plus 501 Hospital Dr Mountain Home AR 72653-2912 Ph: (870) 580-0283 |
| NPI Number | 1023639614 |
|---|---|
| Provider Enumeration Date | 05/05/2020 |
| Last Update Date | 06/22/2023 |
| Medicare PECOS PAC ID | 8325460678 |
|---|---|
| Medicare Enrollment ID | O20200618000246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023639614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Katie E Combs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518155761 PECOS PAC ID: 4183796048 Enrollment ID: I20080709000473 |
| Provider Name | Daniel B Decker |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1205039807 PECOS PAC ID: 8820268840 Enrollment ID: I20110831000332 |
| Provider Name | Julie K Hutchens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639583834 PECOS PAC ID: 9133442114 Enrollment ID: I20141223002004 |
| Provider Name | William Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184063182 PECOS PAC ID: 0941571244 Enrollment ID: I20170804001150 |
| Provider Name | Daniel Pevril |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649811415 PECOS PAC ID: 9133551187 Enrollment ID: I20191113003098 |
| Provider Name | Tosha Marie Applegate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891346862 PECOS PAC ID: 4981000254 Enrollment ID: I20210913000551 |
| Provider Name | Amy L Reano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568054930 PECOS PAC ID: 2961895388 Enrollment ID: I20220208001208 |
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