Individual provider Active NPI

Robin Smith

  • Nurse Practitioner
  • Bentonville, AR
National Provider Identifier
1144783788
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2019002641 Issued in MO
Practice address
10378 Hoot Owl Rd
Bentonville, AR 72712-8612
Phone
(479) 903-2472
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2019002641 MO Primary

Addresses

Primary practice location

10378 Hoot Owl Rd
Bentonville, AR 72712-8612

Mailing address

10378 Hoot Owl Rd
Bentonville, AR 72712-8612
Phone (479) 903-2472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MT, AR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190627002183 MO Practitioner - Nurse Practitioner 5890029664 Reassigns benefits to 1 organization
I20230202000325 MT Practitioner - Nurse Practitioner 5890029664 Reassigns benefits to 1 organization
I20230309002989 AR Practitioner - Nurse Practitioner 5890029664 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC Nurse Practitioner CurrentSince Jun 11, 2023 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Nov 26, 2022 Accepting new patients

Locations

2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767

3011 American Way
Missoula, MT 59808
Phone (406) 546-8745

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1144783788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10378 HOOT OWL RD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128612",
            "telephone_number": "479-903-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10378 HOOT OWL RD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128612",
            "telephone_number": "479-903-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2019002641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.