Individual provider Active NPI

Martha Lynn Brawner, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Fayetteville, AR
National Provider Identifier
1124666482
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
122655 Issued in AR
Practice address
2882 N Bermuda Ave
Fayetteville, AR 72704-6034
Phone
(479) 871-6925
NPI assigned
Dec 18, 2019
Last updated
Dec 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 122655 AR Primary

Addresses

Primary practice location

2882 N Bermuda Ave
Fayetteville, AR 72704-6034

Mailing address

2882 N Bermuda Ave
Fayetteville, AR 72704-6034
Phone (479) 871-6925

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
I20210607000359 AR Practitioner - Nurse Practitioner 5698175081 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SHC Medical Partners of Arkansas LLCGroup PAC ID 2668919812, 28 clinicians

Practice addresses (Care Compare)

200 River Market Ave
Suite 100
Little Rock, AR 72201-1762
Phone (501) 267-9870

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
122655ARMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Care Professionals, LLC CurrentSince Mar 14, 2023 Accepting new patients
Abode Care Partners Al VB, LLC CurrentSince Feb 8, 2025 Accepting new patients
Abode Care Partners LTC VB, LLC CurrentSince Feb 5, 2025 Accepting new patients
Icp Arkansas Aco Billing LLC CurrentSince Mar 14, 2023 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Jun 14, 2021 Accepting new patients
SHC Medical Partners of Arkansas, LLC CurrentSince May 4, 2024 Accepting new patients
Abode Care Partners Al VB, LLC CurrentSince Feb 8, 2025 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Jun 14, 2021 Accepting new patients
Abode Care Partners LTC VB, LLC CurrentSince Feb 5, 2025 Accepting new patients

Locations

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

200 River Market Ave
Ste 100
Little Rock, AR 72201
Phone (501) 267-9870

200 River Market Ave
Ste 500
Little Rock, AR 72201
Phone (501) 492-0099

805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438

805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1124666482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2882 N BERMUDA AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046034",
            "telephone_number": "479-871-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2882 N BERMUDA AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046034",
            "telephone_number": "479-871-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAWNER",
        "first_name": "MARTHA",
        "middle_name": "LYNN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "122655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.