Inis Jane Bardella, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E-12712 Issued in AR

Practice address

1617 N Washington
Magnolia, AR 71753-2046

Phone

(870) 562-2588

NPI assigned

Apr 21, 2006

Last updated

Oct 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1124084926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 W 8TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722042029",
            "telephone_number": "501-686-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 N WASHINGTON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532046",
            "telephone_number": "870-562-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDELLA",
        "first_name": "INIS",
        "middle_name": "JANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-12712",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036129581",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200496730",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS PHYSICIAN LICENSE",
            "identifier": "036129581",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Baldwin Jr., M.ED., ATC, CSCS
• Baptist Health (Baptist Health Medical Center - Magnolia)
• Baptist Health (Baptist Health Specialty Clinic - Magnolia)
• Baptist Health (Baptist Health Home Health Network - Magnolia)
• Baptist Health (Baptist Health Family Clinic - Magnolia)
• Matthew E. Barnett, MD
• Alice Bartushock
• Lynsey Lee Bates, MS CCCSLP
• William David Bates
• Laci Lynn Baurer, ATC

• Family Medicine Physician in Magnolia, AR
• Providers in Magnolia, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.