Individual provider Active NPI

Elizabeth Ann-Grace Burns, APRN

  • Nurse Practitioner
  • Fayetteville, AR
National Provider Identifier
1023627577
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
124191 Issued in AR
Practice address
3344 N Futrall Dr
Fayetteville, AR 72703-4057
Phone
(479) 521-8200
Fax
(479) 582-7329
NPI assigned
Jul 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 124191 AR Primary

Addresses

Primary practice location

3344 N Futrall Dr
Fayetteville, AR 72703-4057

Mailing address

PO Box 1523
Fayetteville, AR 72702-1523
Phone (479) 571-6038

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
I20201022001916 AR Practitioner - Nurse Practitioner 8426478926 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Francis House Nwa, Inc.Group PAC ID 0042262495, 67 clinicians

Practice addresses (Care Compare)

3162 W Martin Luther King Blvd
Fayetteville, AR 72704-7679
Phone (479) 935-4834

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Northwest Arkansas, PA Current Accepting new patients
Medical Associates of Northwest Arkansas PA CurrentSince Sep 1, 2022 Accepting new patients
Washington Regional Medical System CurrentSince Oct 1, 2020 Accepting new patients
Washington Regional Medical System Current Accepting new patients
Washington Regional Medical System CurrentSince Oct 1, 2020 Accepting new patients
Medical Associates of Northwest Arkansas PA CurrentSince Sep 1, 2022 Accepting new patients
Medical Associates of Northwest Arkansas PA Past Accepting new patients
Medical Associates of Northwest Arkansas PA Past Accepting new patients
Medical Associates of Northwest Arkansas PA Past Accepting new patients

Locations

688 E Millsap Rd
Ste 100
Fayetteville, AR 72703
Phone (479) 463-3070

3344 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 582-7213

Interoperability endpoints

  • Direct secure messaging: elizabeth.burns@mana.eclinicaldirectplus.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1023627577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1523",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021523",
            "telephone_number": "479-571-6038",
            "fax_number": "479-582-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3344 N FUTRALL DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034057",
            "telephone_number": "479-521-8200",
            "fax_number": "479-582-7329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "ELIZABETH",
        "middle_name": "ANN-GRACE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "124191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.