Individual provider Active NPI

Rachel Anne Mevissen, MD

  • Family Medicine Physician
  • Little Rock, AR
National Provider Identifier
1154959559
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-17498 Issued in AR
Practice address
13501 Chenal Pkwy Ste 101
Little Rock, AR 72211-5262
Phone
(501) 251-1733
NPI assigned
Mar 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X E-17498 AR Primary

Addresses

Primary practice location

13501 Chenal Pkwy Ste 101
Little Rock, AR 72211-5262

Mailing address

500 Janalyn Cir
Golden Valley, MN 55416-3327
Phone (763) 486-3776

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240624003886 AR Practitioner - Family Practice 9931521127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Integrity Arkansas, PAGroup PAC ID 5496161945, 9 clinicians

Practice addresses (Care Compare)

13501 Chenal Pkwy
Suite 101
Little Rock, AR 72211-5262
Phone (501) 251-1733

Hospital & facility affiliations

  • Elite Home Health Home health agency, Little Rock, AR, CCN 047028
  • Stat Home Health - Cenark, LLC Home health agency, Little Rock, AR, CCN 047117
  • CHI-St Vincent Infirmary Hospital, Little Rock, AR, CCN 040007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1031
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-17498ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Integrity Arkansas PA Family Medicine CurrentSince May 1, 2024 Accepting new patients

Locations

7306 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-2804

13501 Chenal Pkwy
Ste 101
Little Rock, AR 72211
Phone (501) 239-9146

1 Chisholm Trail Rd
Ste 5200
Round Rock, TX 78681
Phone (346) 239-9469

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1154959559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 JANALYN CIR",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554163327",
            "telephone_number": "763-486-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13501 CHENAL PKWY STE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722115262",
            "telephone_number": "501-251-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEVISSEN",
        "first_name": "RACHEL",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-17498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.