MANDY SUZANNE MOONEYHAM PA-C
NPI 1831391655
Physician Assistant - Surgical in Fayetteville, AR

Q: What is Mandy Mooneyham's NPI number?

The NPI number for Mandy Mooneyham is 1831391655. It was assigned to this individual provider in the NPPES registry on June 4, 2007. The provider is also known as Mandy Suzanne Selvey Pa-C.

Q: What is Mandy Mooneyham's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Mandy Mooneyham was last updated on November 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 04, 2007

3053 N COLLEGE AVE, FAYETTEVILLE, AR 72703(479) 463-2000(479) 442-4518 Get Directions Write a Review

NPPES record last updated: November 22, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mandy Suzanne Mooneyham Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MANDY SUZANNE MOONEYHAM PA-C (NPI 1831391655) is an individual surgical provider in Fayetteville, Arkansas, licensed in Arkansas (PA-329) and active in the NPI registry since June 2007.

NPPES Registry Identity

NPI1831391655

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameMANDY SUZANNE MOONEYHAMCredential: PA-C

Location Address3053 N COLLEGE AVEFayetteville, AR 72703-3417

Mailing Address3053 N College AveFayetteville, AR 72703-3417 · (479) 463-2000 · Fax (479) 442-4518

Phone(479) 463-2000

Fax(479) 442-4518

Sole ProprietorNo

Enumeration DateJune 4, 2007

Last NPPES UpdateNovember 22, 2013

✔ NPI 1831391655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

Licenses✔ Licensed in AR · PA-329✔ Licensed in AR · P-T0716✔ Licensed in MO · 2007002747✔ Licensed in OK · 2266

3053 N COLLEGE AVE, Fayetteville, AR 72703

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Other Names 1

Former Name (1)Mandy Suzanne Selvey Pa-c

Other Identifiers 5

Medicaid502277007MO

Medicare PINP00478908MO

Other219705MO · Blue Cross/blue Shield

Other0223808WA · Department Of Labor Wa

Medicare PIN000097457MO

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mandy Mooneyham's NPI number?

The NPI number for Mandy Mooneyham is 1831391655. It was assigned to this individual provider in the NPPES registry on June 4, 2007. The provider is also known as Mandy Suzanne Selvey Pa-C.

Where is Mandy Mooneyham located?

Mandy Mooneyham practices at 3053 N College Ave, Fayetteville, AR 72703. The listed phone number is (479) 463-2000.

What is Mandy Mooneyham's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Mandy Mooneyham was last updated on November 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.