Shanica Nembhard

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

215215 Issued in AR

Practice address

3101 SE 14TH St
Bentonville, AR 72712-4900

Phone

(479) 636-9234

Fax

(479) 636-0774

NPI assigned

Oct 18, 2022

Last updated

Nov 29, 2022By 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 1

Addresses

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  Medicare reassignment NPD
• Mercy Health Northwest Arkansas Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Rogers, AR
  • NPI 1770087371
  NPD

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1124744321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124900",
            "telephone_number": "479-636-9234",
            "fax_number": "479-636-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124900",
            "telephone_number": "479-636-9234",
            "fax_number": "479-636-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMBHARD",
        "first_name": "SHANICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "215215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shanica.nembhard@mercy.net",
            "affiliation": "N",
            "address_1": "3101 SE 14th St",
            "city": "Bentonville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727124900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shanica.nembhard@mercy.net",
            "affiliation": "N",
            "address_1": "3101 SE 14th St",
            "city": "Bentonville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727124900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Neighborhood Dental Services of Nwa, PLLC (My Village Pediatric Dentistry)
• Danny Nicholas Neighbors, PTA
• Whitney Nellore, LPC, NCC
• Alicia Nelson
• Robyn Lea Nelson, M.S., ED.S.
• Stephanie Nesbitt, LAC
• Paul Nesmith
• Olivia May Nettesheim
• Jeffrey A Netzel, O.D.
• Patti Neubert, M.A.

• Pediatrics Physician in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.

Verify at the official NPI Registry.