Active NPI
Deborah Mullens Shirey, DNP, FNP
- Family Nurse Practitioner
- Bentonville, AR
National Provider Identifier
1003805771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A01483
- Practice address
- 1706 SE Walton Blvd.
Ozark Urgent Care
Bentonville, AR 72712 - Phone
- (479) 464-0400
- NPI assigned
- Oct 17, 2005
- Last updated
- Jul 31, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 549052 | TX | |
| Family Nurse Practitioner | 363LF0000X | A01483 | AR | Primary |
Addresses
Primary practice location
1706 SE Walton Blvd.
Ozark Urgent Care
Bentonville, AR 72712
Mailing address
408 JTL Pkwy E
Springdale, AR 72762-8405
Phone (479) 422-8961
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 142199758 | Medicaid | AR | |
| 5W115 | Other | AR | AR BC/BS |
| 1214132-05 | Medicaid | TX |
Other names 1
- Mrs. Deborah Mullens Shirey
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 549052 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Karas Family Walk in Clinic | Current | Accepting new patients | |
| Plano Urgent Care LLC | Past | Accepting new patients | |
| AIDS Resources of Rural Texas | Past | Accepting new patients | |
| Texas Em-1 Medical Services, PA | Past | Accepting new patients | |
| Epoch-Nwa PLLC | Past | Accepting new patients | |
| Hot Springs MRI Center | Past | Accepting new patients | |
| Medical Associates of Northwest Arkansas PA | Past | Accepting new patients | |
| Medical Associates of Northwest Arkansas PA | Past | Accepting new patients | |
| Four States Emergency Physicians | Past | Accepting new patients | |
| AIDS Resources of Rural Texas | Past | Accepting new patients |
Locations
767 W North St
Fayetteville, AR 72701
Phone (479) 521-3600
Interoperability endpoints
- deborah.shirey.1@17617.direct.athenahealth.com
- deborah.shirey.1@17923.direct.athenahealth.com
Organizations & group practices 10
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Primary Care Clinic/Center
- Fayetteville, AR
- NPI 1134542434
-
- General Practice Physician
- Rogers, AR
- NPI 1558897595
-
- Magnetic Resonance Imaging Radiologic Technologist
- Hot Springs, AR
- NPI 1801896410
-
- Family Medicine Physician
- Springdale, AR
- NPI 1831149582
-
- Family Medicine Physician
- Lowell, AR
- NPI 1912883273
-
dba ARRT Health & Wellness Clinic
- Primary Care Nurse Practitioner
- Abilene, TX
- NPI 1932103991
-
- Emergency Medicine Physician
- Texarkana, TX
- NPI 1922051440
-
- Urgent Care Clinic/Center
- Plano, TX
- NPI 1184036899
-
- Physician Assistant
- Texarkana, TX
- NPI 1558314062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406764800000",
"number": "1003805771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "408 JTL PKWY E",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727628405",
"telephone_number": "479-422-8961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1706 SE WALTON BLVD.",
"address_2": "OZARK URGENT CARE",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "72712",
"telephone_number": "479-464-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIREY",
"first_name": "DEBORAH",
"middle_name": "MULLENS",
"name_prefix": "Mrs.",
"credential": "DNP, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-17",
"last_updated": "2014-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "549052",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A01483",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "142199758",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AR BC/BS",
"identifier": "5W115",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1214132-05",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DEBORAH",
"last_name": "SHIREY",
"middle_name": "MULLENS",
"prefix": "MRS.",
"credential": "DNP, FNP",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.