Individual provider Active NPI

Steven Lee McDonald, APRN

  • Nurse Practitioner
  • Booneville, AR
National Provider Identifier
1184865164
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A003209 Issued in AR
Practice address
880 W Main St
Booneville, AR 72927-3420
Phone
(479) 675-2455
Fax
(479) 675-4940
NPI assigned
Mar 20, 2009
Last updated
Dec 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A003209 AR Primary
Family Nurse Practitioner 363LF0000X A03209 ANP AR

Addresses

Primary practice location

880 W Main St
Booneville, AR 72927-3420

Mailing address

880 W Main St
Booneville, AR 72927-3420
Phone (479) 675-2455

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
I20100513001113 AR Practitioner - Nurse Practitioner 3971631888 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1001 Towson Ave
Fort Smith, AR 72901-4921
Phone (479) 441-4000

1902 Fayetteville Rd
Van Buren, AR 72956-6509
Phone (479) 208-5047

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A03209 ANPARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Jan 1, 2023 Accepting new patients
Baptist Medcare, Inc CurrentSince Aug 1, 2021 Accepting new patients
Cisterna Emergency Physicians LLC Past Accepting new patients
Baptist Health Regional Hospitals Past Accepting new patients

Locations

3050 Twin Rivers Dr
Arkadelphia, AR 71923
Phone (501) 202-2300

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

211 Crawford Memorial Dr
Van Buren, AR 72956
Phone (479) 471-4300

Interoperability endpoints

  • Direct secure messaging: smcdonald473787@directb.mercy.net

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": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1184865164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 W MAIN ST",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729273420",
            "telephone_number": "479-675-2455",
            "fax_number": "479-675-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W MAIN ST",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729273420",
            "telephone_number": "479-675-2455",
            "fax_number": "479-675-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "STEVEN",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-20",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A003209",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A03209 ANP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Booneville, AR

Sources for this page

Verify at the official NPI Registry.