Charlena Dian Bagwell, APRN
Individual provider Active NPI Family Nurse Practitioner · Paragould, AR
NPI 1134895170 · NPPES record last updated Sep 13, 2021
Key facts
- NPI
- 1134895170
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 213430 (AR)
- Practice address
- 1110 W Kingshighway
Paragould, AR 72450-4164 - Phone
- (870) 205-2000
- Fax
- (870) 205-2001
- NPI assigned
- Aug 19, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Arkansas Methodist Hospital Corporation
Norman H Buchman and Assoc PC
Practice addresses (Care Compare)
1000 W Kingshighway
Paragould, AR 72450-4197
1108 W Liberty St
Farmington, MO 63640-1922
Phone (978) 335-8344
Hospital & facility affiliations
- Arkansas Methodist Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR, MO
- 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 |
|---|---|---|---|---|
| I20210928000366 | AR | Practitioner - Nurse Practitioner | 8628475076 | Reassigns benefits to 2 organizations |
| I20231108000371 | MO | Practitioner - Nurse Practitioner | 8628475076 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213430 | AR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norman H Buchman & Assoc PC | Current |
Accepting new patients | |
| Arkansas Methodist Hospital Corporation | Family | Current |
Accepting new patients |
Locations
669 Highway 139 N
Monette, AR 72447
Phone (870) 486-5419
900 W Kingshighway
Paragould, AR 72450
Phone (870) 239-7000
1000 W Kingshighway
Ste 14
Paragould, AR 72450
Phone (870) 239-7103
1108 W Liberty St
Farmington, MO 63640
Phone (573) 260-4136
1899 N Westwood Blvd
Ste C
Poplar Bluff, MO 63901
Phone (573) 772-7937
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GIECCA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 213430 | AR | Yes |
Addresses
Primary practice location
1110 W Kingshighway
Paragould, AR 72450-4164
Mailing address
1000 W Kingshighway Ste 14
Paragould, AR 72450-4197
Phone (870) 239-8591
Other practice location 1
1206 Gordon Duckworth Dr
Piggott, AR 72454-1911
Phone (870) 598-3881
Other providers in Paragould, AR
- Christy Nicole Austin
- Kyley Austin
- Tabatha Austin
- Jonathan Gerald Bachelor
- Summer Nicole Bader
- Angela Christine Bailey
- Deanna M Bailey
- Natasha Lee Bailey
- Rebekka Leah Bailey
- Angela Marie Baker
All providers in Paragould, 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 Sep 13, 2021. 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.