Active NPI
Elizabeth Jean Sharp, MD
- Emergency Medicine Physician
- Fayetteville, AR
National Provider Identifier
1124149190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- E-5492
- Practice address
- 3215 N Northhills Blvd
Emergency Dept
Fayetteville, AR 72703-4424 - Phone
- (479) 463-1400
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
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.
-
- Hospitalist Physician
- Fayetteville, AR
- NPI 1306801485
-
- Family Medicine Physician
- Farmington, AR
- NPI 1275839011
-
- Geriatric Psychiatry Physician
- Fayetteville, AR
- NPI 1366408973
-
- Emergency Medicine Physician
- Fayetteville, AR
- NPI 1750334603
NPD (past) EMERGENCY MEDICINE -
- Emergency Medicine Physician
- Hope, AR
- NPI 1235115726
NPD (past) EMERGENCY MEDICINE -
- Infectious Disease Physician
- Fayetteville, AR
- NPI 1346175387
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: Yes
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080715000827 | AR | Practitioner - Emergency Medicine | 1254404882 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-5492 | AR | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington Regional Medical System | Current | Accepting new patients | |
| Washington Regional Medical System | Current | Accepting new patients | |
| Washington Regional Medical System | Current | Accepting new patients | |
| Washington Regional Medical System | Past | Accepting new patients | |
| Arkansas Gatewood Emergency Room Services, PA | Emergency Medicine | Past | Accepting new patients |
| Hope-Hempstead Emegency Group LLC | Emergency Medicine | Past | Accepting new patients |
Locations
3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000
114 E Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 463-2597
609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711
Interoperability endpoints
- esharp39722@washingtonregional.direct-ci.com
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | AR | ||
| Emergency Medicine Physician | 207P00000X | E-5492 | AR | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
3215 N Northhills Blvd
Emergency Dept
Fayetteville, AR 72703-4424
Mailing address
3215 N Northhills Blvd
Emergency Dept
Fayetteville, AR 72703-4424
Phone (479) 463-1400
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5H1866972 | Other | AR | PTAN |
Other names 1
NPPES NPI Registry- Ms. Elizabeth Jean Thacker
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 3, 2015.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422921600000",
"number": "1124149190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3215 N NORTHHILLS BLVD",
"address_2": "EMERGENCY DEPT",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034424",
"telephone_number": "479-463-1400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3215 N NORTHHILLS BLVD",
"address_2": "EMERGENCY DEPT",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034424",
"telephone_number": "479-463-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARP",
"first_name": "ELIZABETH",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2015-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AR",
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "AR",
"license": "E-5492",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "5H1866972",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "THACKER",
"middle_name": "JEAN",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.