Individual provider Active NPI

Corinne Hiser, CNP

  • Nurse Practitioner
  • Mountain Home, AR
National Provider Identifier
1063505147
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AO1400 Issued in AR
Practice address
630 Burnett Dr
Mountain Home, AR 72653-2941
Phone
(870) 425-6971
Fax
(870) 508-8900
NPI assigned
Oct 2, 2006
Last updated
Dec 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 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 AO1400 AR Primary

Addresses

Primary practice location

630 Burnett Dr
Mountain Home, AR 72653-2941

Mailing address

630 Burnett Dr
Mountain Home, AR 72653-2941
Phone (870) 425-6971

Other identifiers 1

IdentifierTypeStateIssuer
170141758MedicaidAR

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
I20080516000674 AR Practitioner - Nurse Practitioner 6507935541 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AO1400ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1063505147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 BURNETT DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532941",
            "telephone_number": "870-425-6971",
            "fax_number": "870-508-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 BURNETT DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532941",
            "telephone_number": "870-425-6971",
            "fax_number": "870-508-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISER",
        "first_name": "CORINNE",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "AO1400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170141758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

Verify at the official NPI Registry.