Individual provider Active NPI

Sunni Tollett, APRN

  • Family Nurse Practitioner
  • Nashville, AR
National Provider Identifier
1205415791
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
216294 Issued in AR
Practice address
114 S Main St
Nashville, AR 71852-2406
Phone
(870) 845-0033
NPI assigned
Apr 3, 2021
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R86623 AR
Family Nurse Practitioner 363LF0000X 216294 AR Primary

Addresses

Primary practice location

114 S Main St
Nashville, AR 71852-2406

Mailing address

602 Dequeen St
Mena, AR 71953-3218
Phone (870) 582-4429

Other practice location 1

602 Dequeen St
Mena, AR 71953-3218
Phone (479) 394-1134

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
I20210728003273 AR Practitioner - Nurse Practitioner 7315340312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Ferguson Health Care IncGroup PAC ID 7113004664, 2 clinicians

Practice addresses (Care Compare)

114 S Main St
Nashville, AR 71852-2406
Phone (870) 845-0033

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R86623ARMDRegistered Nurse
216294ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ferguson Health Care Inc CurrentSince Jul 15, 2021 Accepting new patients
Mena Medical Center Hospice, LLC PastSince Apr 1, 2021 Accepting new patients

Locations

114 S Main St
Nashville, AR 71852
Phone (870) 845-0033

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHFIAD/Endpoint/GHFIAD

Organizations & group practices 2

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 2

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": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1205415791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 DEQUEEN ST",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719533218",
            "telephone_number": "870-582-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S MAIN ST",
            "city": "NASHVILLE",
            "state": "AR",
            "postal_code": "718522406",
            "telephone_number": "870-845-0033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Dequeen St",
            "address_purpose": "LOCATION",
            "city": "Mena",
            "state": "AR",
            "postal_code": "719533218",
            "country_code": "US",
            "telephone_number": "479-394-1134",
            "fax_number": "479-394-2056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLLETT",
        "first_name": "SUNNI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-03",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R86623",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "216294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, AR

Sources for this page

Verify at the official NPI Registry.