Individual provider Active NPI

Mindy Kazery, APRN, NP-C

  • Family Nurse Practitioner
  • Fayetteville, AR
National Provider Identifier
1164804209
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004432 Issued in AR
Practice address
1057 N Garland Ave
Fayetteville, AR 72701-1722
Phone
(479) 966-5088
NPI assigned
Jun 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A004432 AR Primary

Addresses

Primary practice location

1057 N Garland Ave
Fayetteville, AR 72701-1722

Mailing address

1057 N Garland Ave
Fayetteville, AR 72701-1722
Phone (479) 966-5088

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
I20150904000290 AR Practitioner - Nurse Practitioner 0941516108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Karas Family Walk in ClinicGroup PAC ID 4688899883, 8 clinicians

Practice addresses (Care Compare)

114 Harrison Ave
Lowell, AR 72745-9047
Phone (479) 770-4343

212 S Lincoln St
Lowell, AR 72745-9782
Phone (479) 770-4343

767 W N St
Fayetteville, AR 72701-1865
Phone (479) 966-5088

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Karas Family Walk in Clinic CurrentSince Jul 1, 2015 Accepting new patients
Karas Family Walk-in Clinic Family Past Accepting new patients
Karas Walk-in Clinic Family Past Accepting new patients

Locations

1057 N Garland Ave
Fayetteville, AR 72701
Phone (479) 966-5088

767 W North St
Fayetteville, AR 72701
Phone (479) 521-3600

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.

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1164804209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 N GARLAND AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727011722",
            "telephone_number": "479-966-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 N GARLAND AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727011722",
            "telephone_number": "479-966-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZERY",
        "first_name": "MINDY",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.