Individual provider Active NPI

Virginia Mistler, APRN

  • Family Nurse Practitioner
  • Dardanelle, AR
National Provider Identifier
1174496871
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
234951 Issued in AR
Practice address
1714 State Highway 22 W
Dardanelle, AR 72834-2907
Phone
(479) 477-3084
Fax
(479) 477-3085
NPI assigned
Sep 29, 2025
Sex
Female
Sole proprietor
No

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
Family Nurse Practitioner 363LF0000X 234951 AR Primary

Addresses

Primary practice location

1714 State Highway 22 W
Dardanelle, AR 72834-2907

Mailing address

1714 State Highway 22 W
Dardanelle, AR 72834-2907
Phone (479) 477-3084

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
I20251123000102 AR Practitioner - Nurse Practitioner 1052803418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Physician Services LLCGroup PAC ID 4981698032, 49 clinicians

Practice addresses (Care Compare)

1714 Hwy 22
Dardanelle, AR 72834-2907
Phone (479) 477-3084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234951ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Marys Physician Services, LLC CurrentSince Dec 30, 2025 Accepting new patients
St Mary'S Physician Services LLC CurrentSince Dec 30, 2025 Accepting new patients
St Marys Physician Services, LLC Past Accepting new patients

Locations

1714 State Highway 22 W
Dardanelle, AR 72834
Phone (479) 229-2566

101 Skyline Dr
Russellville, AR 72801
Phone (479) 968-2345

Interoperability endpoints

  • Direct secure messaging: virginia.mistler.1@2433.direct.athenahealth.com

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": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1174496871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 STATE HIGHWAY 22 W",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728342907",
            "telephone_number": "479-477-3084",
            "fax_number": "479-477-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 STATE HIGHWAY 22 W",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728342907",
            "telephone_number": "479-477-3084",
            "fax_number": "479-477-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTLER",
        "first_name": "VIRGINIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "234951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dardanelle, AR

Sources for this page

Verify at the official NPI Registry.