KALLY MARIE ELIZABETH SIVAGE (NPI# 1740762905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740762905 |
| Entity Type | Individual |
| Full Name | KALLY MARIE ELIZABETH SIVAGE |
| Practice Address |
10301 Mayo Dr Barling AR 72923-1660 |
| Mailing Address |
119 Dartmouth Ln Fort Smith AR 72908-8200 |
| Practice Telephone | 4794945700 |
| Mailing Telephone | 4795619583 |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2018-09-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
A005843 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10301 MAYO DR |
| City | BARLING |
| State | AR |
| Zip Code | 72923-1660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326034547 | Terrell P Bishop | Psychiatry & Neurology | 10301 Mayo Dr, Barling, AR 72923-1660 | 2005-09-22 |
| 1124630223 | Alexandra Tiffany Essid | Nurse Practitioner | 10301 Mayo Dr, Barling, AR 72923-1660 | 2020-08-19 |
| 1750942215 | Kelley Danielle Hale | Nurse Practitioner | 10301 Mayo Dr, Barling, AR 72923-1660 | 2019-06-25 |
| 1154707461 | Valley Behavioral Health System, LLC | Psychiatric Residential Treatment Facility | 10301 Mayo Dr, Barling, AR 72923-1660 | 2015-08-10 |
| 1629478946 | Lisa G Brock | Counselor | 10301 Mayo Dr, Barling, AR 72923-1660 | 2014-08-25 |
| 1124466701 | Phomakay Primary Care Pa | Family Medicine | 10301 Mayo Dr, Barling, AR 72923-1660 | 2013-06-05 |
| 1154674661 | Saige E Small | Case Manager/Care Coordinator | 10301 Mayo Dr, Barling, AR 72923-1660 | 2012-10-22 |
| 1811242233 | Savannah Keeter | Case Manager/Care Coordinator | 10301 Mayo Dr, Barling, AR 72923-1660 | 2012-07-23 |
| 1922369495 | James Vitale | Case Manager/Care Coordinator | 10301 Mayo Dr, Barling, AR 72923-1660 | 2012-05-31 |
| 1013278563 | Lauren Patton | Case Manager/Care Coordinator | 10301 Mayo Dr, Barling, AR 72923-1660 | 2012-05-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831702182 | Marshall Sebastian Parker | Chiropractor | 7209 Chad Colley Blvd, Suite A, Barling, AR 72923 | 2020-08-26 |
| 1912568304 | Community Family Medical Clinic, LLC. | Family Medicine | 1202 Fort Street, Barling, AR 72923 | 2019-06-26 |
| 1548718125 | Chandra Mathis | Nurse Practitioner | 1200 Fort St, Barling, AR 72923 | 2016-09-13 |
| 1982961439 | Valley Behavioral Health System LLC | Psychiatric Hospital | 10301 Mayo Drive, Barling, AR 72923 | 2012-04-20 |
| 1013162031 | Dana Smith | Case Manager/Care Coordinator | 1311 Fort Street, Ste J, Barling, AR 72923 | 2008-11-18 |
| 1861643116 | Peter Nguyen | Case Manager/Care Coordinator | 1311 Fort Smith, Barling, AR 72923 | 2008-10-06 |
| 1346464120 | Alert Response, LLC | Durable Medical Equipment & Medical Supplies | 618 Fort Street, Bartling, AR 72923 | 2007-04-12 |
| 1043346752 | Jenny Burton | Case Manager/Care Coordinator | 1311 Fort St., Suite J, Barling, AR 72923 | 2007-02-26 |
| 1922142454 | Edward R Obana Jr. | Social Worker | 1311 Fort Street, Suite J, Barling, AR 72923 | 2007-02-17 |
| 1730198110 | Health Depot Pharmacies, LLC | Durable Medical Equipment & Medical Supplies | 1610 Fort Street, Barling, AR 72923 | 2006-08-05 |
| Find all providers in zip 72923 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750942215 | Kelley Danielle Hale | Nurse Practitioner | 10301 Mayo Dr, Barling, AR 72923-1660 | 2019-06-25 |
| 1619487733 | Kimberlee Sartain | Nurse Practitioner | 815 Fort St Ste A, Barling, AR 72923-2180 | 2017-10-03 |
| 1346339066 | Bethany Allison Tosh | Nurse Practitioner | 10301 Mayo Dr, Barling, AR 72923-1660 | 2006-10-12 |
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|---|---|---|---|---|
| 1326647918 | Coco Psychiatric Services Pllc | Nurse Practitioner | 115 Bella Rosa Pl, Little Rock, AR 72223-4771 | 2020-10-23 |
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| 1457968737 | Natural State Behavioral Health | Nurse Practitioner | 1401 Malvern Ave Ste 180, Hot Springs, AR 71901-6370 | 2020-09-30 |
| 1255944559 | The Clinic At The Forging Place | Nurse Practitioner | 1302 Cherry St, Van Buren, AR 72956-4543 | 2020-08-26 |
| 1508478066 | Jaleesa Shears | Nurse Practitioner | 880 Bayou Vista Dr, Marion, AR 72364-5006 | 2020-08-17 |
| 1306455860 | Wendy Michelle Ray | Nurse Practitioner | 1012 E Church St Ste A, Warren, AR 71671-3530 | 2020-07-29 |
| 1295352771 | Mindful Rx LLC | Nurse Practitioner | 501 Commerce Dr Unit 13341, Maumelle, AR 72113-7729 | 2020-06-30 |
| 1235755638 | Jason David Wallace | Nurse Practitioner | 2616 Gallaway Cv, Jonesboro, AR 72404-7827 | 2020-06-22 |
| 1891319745 | Heather Nichole Fesperman | Nurse Practitioner | 420 W Cooper Ave, West Memphis, AR 72301 | 2020-06-05 |
| 1588299291 | Chastity Qg Stephens | Nurse Practitioner | 2607 Alford Cv, Bryant, AR 72022-7527 | 2020-03-03 |
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| 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.