Charlotte Jane Stark, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

219426 Issued in AR

Practice address

2800 Fayetteville Rd
Van Buren, AR 72956-6523

Phone

(479) 314-4000

Fax

(479) 314-4050

NPI assigned

Jul 8, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO, AR2 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 2

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, 361 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: npstark@hrrmcmedicalclinics.ssdirect.aprima.com

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.

• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment Care Compare group NPD
• Salida Hospital District

  • Internal Medicine Physician
  • Salida, CO
  • NPI 1972778272
  Medicare reassignment NPD
• Mercy Clinic Fort Smith Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Smith, AR
  • NPI 1790258002
  NPD
• Salida Hospital District

  • Rural Health Clinic/Center
  • Buena Vista, CO
  • NPI 1427395193
  NPD
• Salida Hospital District

  • Critical Access Hospital
  • Salida, CO
  • NPI 1730258971
  NPD
• Elane Shirar MD Inc

  • Family Medicine Physician
  • Northglenn, CO
  • NPI 1134227291
  NPD (past)
• Simms Crossing Family Practice Inc

  • Family Medicine Physician
  • Golden, CO
  • NPI 1003854480
  NPD (past)

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

• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1174521702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 FAYETTEVILLE RD",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729566523",
            "telephone_number": "479-314-4000",
            "fax_number": "479-314-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 FAYETTEVILLE RD",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729566523",
            "telephone_number": "479-314-4000",
            "fax_number": "479-314-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 Edwards St",
            "address_purpose": "LOCATION",
            "city": "Westcliffe",
            "state": "CO",
            "postal_code": "812528588",
            "country_code": "US",
            "telephone_number": "719-783-2380",
            "fax_number": "719-783-2377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "CHARLOTTE",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "80977",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "219426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKY MTN HEALTH PLANS",
            "identifier": "84-1090521008",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500027209",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npstark@hrrmcmedicalClinics.ssdirect.aprima.com",
            "affiliation": "Y",
            "affiliationName": "Salida Hospital District",
            "address_1": "1000 Rush Dr",
            "city": "Salida",
            "state": "CO",
            "country_code": "US",
            "postal_code": "812019627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cody Marie Sparks
• Kendall Don Spinas
• Spinehaven Chiropractic PLLC
• Spirit Med, Incorporated
• St Edward Medical Services, Inc.
• Shannon Stephen, PTA
• Whitley Dawn Stewart, RN
• Kayla Stiles, PTA
• Skyler Elizabeth Storment
• Fritzie Suggs

• Family Nurse Practitioner in Van Buren, AR
• Providers in Van Buren, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.