John Mark Bates, APRN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Malvern, AR
NPI 1114524436 · NPPES record last updated Nov 19, 2020
Key facts
- NPI
- 1114524436
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 212918 (AR)
- Practice address
- 1002 Schneider Dr Ste 104
Malvern, AR 72104-4823 - Phone
- (501) 337-9994
- NPI assigned
- Oct 9, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Covenant Health LLC
Practice addresses (Care Compare)
1580 Tanner St
Rockport, AR 72104-2023
Phone (501) 337-9994
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201124001875 | AR | Practitioner - Nurse Practitioner | 8022429067 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212918 | AR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shane Higginbotham MD PA | Current |
Accepting new patients | |
| Covenant Health LLC | Current |
Accepting new patients |
Locations
1002 Schneider Dr
Ste 104
Malvern, AR 72104
Phone (501) 337-9066
1580 Tanner St
Rockport, AR 72104
Phone (501) 337-9994
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CBCDCA/Endpoint/CBCDCA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 212918 | AR | Yes |
Addresses
Primary practice location
1002 Schneider Dr Ste 104
Malvern, AR 72104-4823
Mailing address
1002 Schneider Dr
Ste 104
Malvern, AR 72104-4823
Phone (501) 467-4665
Other providers in Malvern, AR
- Barbara Lazerus Crna Ms
- Ryver Barham
- Shayla Barnes-Miller
- Jamie Barnett
- Teresa Gail Bashaw
- Patrick Beasley
- Bernice Bedford
- Amy M Bennett
- Emily Berry
- Birch Tree Communities, Inc
All providers in Malvern, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.