Individual provider Active NPI

Allison Annakay Debooserie, APRN

  • Family Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1104306588
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
230356 Issued in AR
Practice address
9500 Kanis Rd Ste 501
Little Rock, AR 72205-6389
Phone
(501) 227-9080
Fax
(501) 227-0490
NPI assigned
Aug 15, 2018
Reactivated
Nov 25, 2024
Last updated
Nov 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 230356 AR Primary

Addresses

Primary practice location

9500 Kanis Rd Ste 501
Little Rock, AR 72205-6389

Mailing address

3196 McKensie Dr
Benton, AR 72015-4989
Phone (870) 299-2285

Other names 1

  • Allison Annakay Farmer Former name

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
I20241209001884 AR Practitioner - Nurse Practitioner 3779019138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

9500 Kanis Rd
Suite 501
Little Rock, AR 72205-6389
Phone (501) 227-9080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230356ARMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: adebooserie782150@direct.baptist-healthar.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1104306588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 MCKENSIE DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154989",
            "telephone_number": "870-299-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 KANIS RD STE 501",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056389",
            "telephone_number": "501-227-9080",
            "fax_number": "501-227-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOOSERIE",
        "first_name": "ALLISON",
        "middle_name": "ANNAKAY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "deactivation_date": "2024-11-11",
        "reactivation_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "230356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "FARMER",
            "middle_name": "ANNAKAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.