Haley M Quintana

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

125493 Issued in AR

Practice address

1617 N Washington # 599
Magnolia, AR 71753-2046

Phone

(870) 234-7676

Fax

(870) 562-2559

NPI assigned

Jun 27, 2020

Last updated

Nov 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Haley M Moore Former name

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Medical Group LLCGroup PAC ID 1153413786, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Magnolia Home Health Agency Home health agency, Magnolia, AR, CCN 047081
• Magnolia Regional Medical Center Hospital, Magnolia, AR, CCN 041336
• Magnolia Regional Medical Center Hospital, Magnolia, AR, CCN 040067

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Southern Medical Group LLC

  • Family Medicine Physician
  • Magnolia, AR
  • NPI 1073544508
  Medicare reassignment Care Compare group NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  NPD (past)

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

• Magnolia Regional Health System Inc

  • Home Health Agency
  • Magnolia, AR
  • NPI 1336760362
  Care Compare affiliation
• Magnolia Regional Health System Inc

  dba Magnolia Regional Medical Center

  • Critical Access Hospital
  • Magnolia, AR
  • NPI 1700407541
  Care Compare affiliation

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

{
    "created_epoch": "1593216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1083231807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251420",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251420",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 N WASHINGTON # 599",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532046",
            "telephone_number": "870-234-7676",
            "fax_number": "870-562-2559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N West Ave",
            "address_purpose": "LOCATION",
            "city": "El Dorado",
            "state": "AR",
            "postal_code": "717304654",
            "country_code": "US",
            "telephone_number": "870-466-4308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINTANA",
        "first_name": "HALEY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-27",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "125493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "MOORE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kennedy Powell
• Madison Jewel Powell, APRN
• Shawntel Marie Price, APRN
• Jeffrey Dale Prince, PD
• Professional Counseling Services of Magnolia
• Ricodaro Rainey
• Mercedes Ray, LCSW
• Jennifer Rayburn, MHPP
• Brittany Gayle Reeves, PT, DPT
• Cami Elizabeth Riggins

• Family Nurse Practitioner in Magnolia, AR
• Providers in Magnolia, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.