Individual provider Active NPI

Mary A Linn, PA-C

  • Medical Physician Assistant
  • Van Buren, AR
National Provider Identifier
1013149798
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
620 Broadway St
Van Buren, AR 72956-5830
Phone
(479) 474-5061
Fax
(479) 922-2007
NPI assigned
Aug 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA383 AR
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

620 Broadway St
Van Buren, AR 72956-5830

Mailing address

620 Broadway St
Van Buren, AR 72956-5830
Phone (479) 474-5061

Other identifiers 2

IdentifierTypeStateIssuer
200257920AMedicaidOK
179073741MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090916000082 AR Practitioner - Physician Assistant 4284780255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sophia Meyer Family Medicine LLCGroup PAC ID 9537317219, 3 clinicians

Practice addresses (Care Compare)

620 Broadway St
Van Buren, AR 72956-5830
Phone (479) 474-5061

Hospital & facility affiliations

  • Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055
  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA383ARMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group, Arkansas, PA Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1013149798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 BROADWAY ST",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729565830",
            "telephone_number": "479-474-5061",
            "fax_number": "479-922-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 BROADWAY ST",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729565830",
            "telephone_number": "479-474-5061",
            "fax_number": "479-922-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINN",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": "PA383",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200257920A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179073741",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Buren, AR

Sources for this page

Verify at the official NPI Registry.