Seth Thomas Tolliver, APN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A03244 ANP Issued in AR

Practice address

101 Master Sergeant Dan Wassom
Little Rock Afb, AR 72099-0001

Phone

(501) 987-5474

NPI assigned

Jun 4, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1104052158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MASTER SERGEANT DAN WASSOM",
            "city": "LITTLE ROCK AFB",
            "state": "AR",
            "postal_code": "720990001",
            "telephone_number": "501-987-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MASTER SERGEANT DAN WASSOM",
            "city": "LITTLE ROCK AFB",
            "state": "AR",
            "postal_code": "720990001",
            "telephone_number": "501-987-5474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1090 Arnold Dr",
            "address_purpose": "LOCATION",
            "city": "Lr AFB",
            "state": "AR",
            "postal_code": "720990001",
            "country_code": "US",
            "telephone_number": "501-987-8811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLLIVER",
        "first_name": "SETH",
        "middle_name": "THOMAS",
        "credential": "APN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-04",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A03244 ANP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Little Rock Afb, AR
• Providers in Little Rock Afb, 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 Sep 9, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.