Individual provider Active NPI

Joann Mahan, APRN

  • Family Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1104225317
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004261 Issued in AR
Practice address
3416 Old Greenwood Rd
Fort Smith, AR 72903-5462
Phone
(479) 242-2888
Fax
(479) 242-2889
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X R43284 AR
Family Nurse Practitioner 363LF0000X A004261 AR Primary

Addresses

Primary practice location

3416 Old Greenwood Rd
Fort Smith, AR 72903-5462

Mailing address

3416 Old Greenwood Rd
Fort Smith, AR 72903-5462
Phone (479) 242-2888

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
I20150714000348 AR Practitioner - Nurse Practitioner 2062725534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Danny Silver MD PLLCGroup PAC ID 0244524072, 4 clinicians

Practice addresses (Care Compare)

708 Lexington Ave
Fort Smith, AR 72901-4738
Phone (479) 226-3132

Hospital & facility affiliations

  • Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A004261ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Danny Silver M.D. PLLC CurrentSince Apr 1, 2020 Accepting new patients

Locations

350 E Millsap Rd
Fayetteville, AR 72703
Phone (479) 442-4495

708 Lexington Ave
Fort Smith, AR 72901
Phone (479) 226-3132

Interoperability endpoints

  • Direct secure messaging: joann.mahan.1@28186.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1104225317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3416 OLD GREENWOOD RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035462",
            "telephone_number": "479-242-2888",
            "fax_number": "479-242-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 OLD GREENWOOD RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035462",
            "telephone_number": "479-242-2888",
            "fax_number": "479-242-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "JOANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "AR",
            "license": "R43284",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.