DR. MARA ELIZABETH WHITESIDE (PHD) – Clinical Neuropsychologist, NPI 1013408137
Clinical Neuropsychologist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. MARA ELIZABETH WHITESIDE (PHD)
5869, Cord Avenue, Spring Creek, Springdale, Benton County, Arkansas, 72762, United States
SPRINGDALE, AR 727621811
Phone: (479) 426-1703
Type: Mailing
204, South 24th Street, Rogers, Benton County, Arkansas, 72758, United States
ROGERS, AR 727581129
Phone: (479) 621-0301
Type: Location
2575 S. GENE GEORGE BLVD
STE. 100
SPRINGDALE, AR 72762
Phone: (479) 750-0125
Type: Mailing
2575 S. GENE GEORGE BLVD.
STE. 100
SPRINGDALE, AR 72762
Phone: (479) 750-0125
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-02-18
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190218001755 | I | Clinical Psychologist | AR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 72762)
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