Individual provider Active NPI

Gregory Scott Forrester, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gravette, AR
National Provider Identifier
1184284473
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
120678 Issued in AR
Practice address
1101 Jackson St SW
Gravette, AR 72736-9121
Phone
(479) 344-6870
Fax
(479) 344-6865
NPI assigned
Jun 18, 2019
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 120678 AR Primary

Addresses

Primary practice location

1101 Jackson St SW
Gravette, AR 72736-9121

Mailing address

1101 Jackson St SW
Gravette, AR 72736-9121
Phone (479) 344-6870

Other practice location 1

102 Russell Rd
Rogers, AR 72756-9319
Phone (479) 278-7189

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
I20190722002997 AR Practitioner - Nurse Practitioner 3971839408 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sgoh Acquisition IncGroup PAC ID 5092616276, 95 clinicians

Practice addresses (Care Compare)

102 Russell Rd
Rogers, AR 72756-9319
Phone (479) 278-7189

346 N Main St
Decatur, AR 72722-9732
Phone (479) 752-3233

4253 N Crossover Rd
Fayetteville, AR 72703-4593
Phone (479) 521-5731

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texarkana Behavioral Associates LC CurrentSince Jan 20, 2021 Accepting new patients
Texarkana Behavioral Associates, L.C. Current Accepting new patients
Sgoh Acquisition Inc CurrentSince Jul 1, 2019 Accepting new patients
Texarkana Behavioral Associates, L.C. CurrentSince Jan 20, 2021 Accepting new patients
Sgoh Acquisition Inc CurrentSince Jul 1, 2019 Accepting new patients

Locations

815 Fort St
Ste A
Barling, AR 72923
Phone (479) 494-5740

4253 N Crossover Rd
Fayetteville, AR 72703
Phone (479) 443-6496

1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221

102 Russell Rd
Rogers, AR 72756
Phone (479) 278-7189

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1184284473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 JACKSON ST SW",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369121",
            "telephone_number": "479-344-6870",
            "fax_number": "479-344-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 JACKSON ST SW",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369121",
            "telephone_number": "479-344-6870",
            "fax_number": "479-344-6865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Russell Rd",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727569319",
            "country_code": "US",
            "telephone_number": "479-278-7189",
            "fax_number": "479-278-2199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORRESTER",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "120678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gravette, AR

Sources for this page

Verify at the official NPI Registry.