Individual provider Active NPI

Tyler Parker, PA-C

  • Physician Assistant
  • Fort Smith, AR
National Provider Identifier
1164300349
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1433 Issued in AR
Practice address
7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone
(479) 314-6000
NPI assigned
Aug 25, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA1433 AR Primary

Addresses

Primary practice location

7301 Rogers Ave
Fort Smith, AR 72903-4100

Mailing address

PO Box 7796084
Chicago, IL 60677-6084
Phone (479) 314-6240

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
I20251124002622 AR Practitioner - Physician Assistant 8022500370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Louisiana State University School of Medicine in Shreveport, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-5175

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1433ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities Multi-Specialty CurrentSince Nov 1, 2025 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Nov 1, 2025 Accepting new patients
Mercy Hospital Fort Smith Multi-Specialty Past 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

Organizations & group practices 3

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 1

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": "1756080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1164300349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7796084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "479-314-6240",
            "fax_number": "479-452-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034100",
            "telephone_number": "479-314-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "TYLER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA1433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.