NPIMap

Individual provider Active NPI

Emily J Coombs, APRN

  • Adult Health Nurse Practitioner
  • Fayetteville, AR
National Provider Identifier
1073745873
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
S002242 Issued in AR
Practice address
12 E Appleby Rd
Suite 101
Fayetteville, AR 72703
Phone
(479) 463-4444
Fax
(479) 463-4499
NPI assigned
Aug 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X S02242 AR
Adult Health Nurse Practitioner 363LA2200X S002242 AR Primary

Addresses

Primary practice location

12 E Appleby Rd
Suite 101
Fayetteville, AR 72703

Mailing address

PO Box 550
Lowell, AR 72745
Phone (479) 463-7775

Other identifiers 1

IdentifierTypeStateIssuer
180302758MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110712000121 AR Practitioner - Certified Clinical Nurse Specialist (CNS) 8123165008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington Regional Medical SystemGroup PAC ID 8820995434, 238 clinicians

Practice addresses (Care Compare)

12 E Appleby Rd
Suite 101
Fayetteville, AR 72703-3928
Phone (479) 463-4444

Hospital & facility affiliations

  • Elite Home Health Home health agency, Springdale, AR, CCN 047346
  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S002242ARMDAdult Health Nurse Practitioner
S02242ARMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System CurrentSince Nov 1, 2014 Accepting new patients
Washington Regional Medical System CurrentSince Nov 1, 2014 Accepting new patients
Washington Regional Medical System Past Accepting new patients

Locations

12 E Appleby Rd
Ste 101
Fayetteville, AR 72703
Phone (479) 463-4444

Interoperability endpoints

  • Direct secure messaging: ecoombs26950@washingtonregional.direct-ci.com

Organizations & group practices 13

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.

View all 13

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": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1073745873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "72745",
            "telephone_number": "479-463-7775",
            "fax_number": "479-463-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 E APPLEBY RD",
            "address_2": "SUITE 101",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-463-4444",
            "fax_number": "479-463-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMBS",
        "first_name": "EMILY",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "S02242",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "S002242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180302758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.