Active NPI
Brenna Rainwater
- Registered Nurse
- Fort Smith, AR
National Provider Identifier
1104241892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R084735
- Practice address
- 6601 Phoenix Ave
Suite B
Fort Smith, AR 72903-5092 - Phone
- (479) 785-9091
- NPI assigned
- Mar 4, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R084735 | AR | Primary |
Addresses
Primary practice location
6601 Phoenix Ave
Suite B
Fort Smith, AR 72903-5092
Mailing address
6601 Phoenix Ave
Suite B
Fort Smith, AR 72903-5092
Phone (479) 785-9091
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R084735 | AR | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Arkansas for Medical Sciences | Past | Accepting new patients | |
| University of Arkansas for Medical Sciences | 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 and National Provider Directory roles.
-
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- Little Rock, AR
- NPI 1346230968
-
- Internal Medicine Physician
- Little Rock, AR
- NPI 1588654016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393891200000",
"number": "1104241892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6601 PHOENIX AVE",
"address_2": "SUITE B",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729035092",
"telephone_number": "479-785-9091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6601 PHOENIX AVE",
"address_2": "SUITE B",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729035092",
"telephone_number": "479-785-9091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAINWATER",
"first_name": "BRENNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-04",
"last_updated": "2014-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AR",
"license": "R084735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.