Individual provider Active NPI

Kristen Coffman, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1104312420
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ATP-001331 Issued in AR
Practice address
400 Hardin Rd Ste 150
Little Rock, AR 72211-3507
Phone
(501) 603-2147
Fax
(501) 603-0204
NPI assigned
Jul 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ATP-001331 AR Primary

Addresses

Primary practice location

400 Hardin Rd Ste 150
Little Rock, AR 72211-3507

Mailing address

400 Hardin Rd Ste 150
Little Rock, AR 72211-3507
Phone (501) 603-2147

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
I20200421002612 AR Practitioner - Nurse Practitioner 7719317445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1857 Rice St
Waldron, AR 72958-7724
Phone (479) 637-2468

3109 S 70TH St
Fort Smith, AR 72903-5017
Phone (479) 452-9490

3111 S 70TH St
Fort Smith, AR 72903-5017
Phone (479) 452-6650

3113 S 70TH St
Fort Smith, AR 72903-5017
Phone (479) 478-6664

3117 S 70TH St
The Guidance Center Primary Care
Fort Smith, AR 72903-5017
Phone (479) 785-9400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ATP-001331ARMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Arkansas Counseling & Guidance Center, Inc Current Accepting new patients
The Guidance Center - Whole Health Psychiatric/Mental Health CurrentSince Dec 29, 2024 Accepting new patients
Valley Behavioral Health System LLC CurrentSince Apr 13, 2020 Accepting new patients
Valley Behavioral Health System, LLC CurrentSince Apr 13, 2020 Accepting new patients
The Guidance Center - Mena Clinic CurrentSince Dec 29, 2024 Accepting new patients

Locations

10301 Mayo Dr
Barling, AR 72923
Phone (479) 494-5760

3113 S 70th St
Fort Smith, AR 72903
Phone (479) 478-6664

3111 S 70th St
Fort Smith, AR 72903

1857 Rice St
Waldron, AR 72958
Phone (479) 637-2468

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1104312420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HARDIN RD STE 150",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113507",
            "telephone_number": "501-603-2147",
            "fax_number": "501-603-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HARDIN RD STE 150",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113507",
            "telephone_number": "501-603-2147",
            "fax_number": "501-603-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "KRISTEN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "ATP-001331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.