Individual provider Active NPI

Reilly Roberts, FNP

  • Family Nurse Practitioner
  • Bentonville, AR
National Provider Identifier
1194684720
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
236216 Issued in AR
Practice address
1720 S Walton Blvd Ste 6
Bentonville, AR 72712-7533
Phone
(479) 464-0834
NPI assigned
Jan 20, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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 236216 AR Primary

Addresses

Primary practice location

1720 S Walton Blvd Ste 6
Bentonville, AR 72712-7533

Mailing address

3607 SW 106TH St
Gainesville, FL 32608-9177
Phone (662) 588-9889

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
I20260205000659 AR Practitioner - Nurse Practitioner 7810476322

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3607 SW 106TH St
Gainesville, FL 32608-9177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236216ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Farm Clinic Family CurrentSince Jan 20, 2026 Accepting new patients

Locations

1720 S Walton Blvd
Ste 6
Bentonville, AR 72712
Phone (479) 464-0834

Organizations & group practices 1

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": "1768867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1194684720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 SW 106TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326089177",
            "telephone_number": "662-588-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S WALTON BLVD STE 6",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127533",
            "telephone_number": "479-464-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "REILLY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-20",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "236216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.