Individual provider Active NPI

Staci Herndon Gathright, FNP

  • Family Nurse Practitioner
  • Rogers, AR
National Provider Identifier
1023254257
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A003219 Issued in AR
Practice address
2708 Rife Medical Lane
Suite 130
Rogers, AR 72758
Phone
(479) 338-5555
Fax
(479) 338-5533
NPI assigned
Dec 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A003219 AR Primary

Addresses

Primary practice location

2708 Rife Medical Lane
Suite 130
Rogers, AR 72758

Mailing address

2708 Rife Medical Lane
Suite 130
Rogers, AR 72758-1452
Phone (479) 338-5555

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
I20090316000275 AR Practitioner - Nurse Practitioner 6103983341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Arkansas College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2708 S Rife Medical LN
Suite 130
Rogers, AR 72758-1455
Phone (479) 338-5555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Feb 3, 2009 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Feb 3, 2009 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

2708 S Rife Medical Ln
Ste 130
Rogers, AR 72758
Phone (479) 338-5555

2708 S Rife Medical Ln
Ste T30
Rogers, AR 72758
Phone (479) 338-3999

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

2708 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-3030

Interoperability endpoints

  • Direct secure messaging: sgathright19940@directc.mercy.net

Organizations & group practices 3

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 1

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": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1023254257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 RIFE MEDICAL LANE",
            "address_2": "SUITE 130",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-5555",
            "fax_number": "479-338-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 RIFE MEDICAL LANE",
            "address_2": "SUITE 130",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-338-5555",
            "fax_number": "479-338-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATHRIGHT",
        "first_name": "STACI",
        "middle_name": "HERNDON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-17",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A003219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.