Individual provider Active NPI

Nickey Noid, APN

  • Acute Care Nurse Practitioner
  • Bryant, AR
National Provider Identifier
1235796145
Registry record updated May 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
A006262 Issued in AR
Practice address
1709 Cedar Dr
Bryant, AR 72019-6378
Phone
(501) 838-8934
NPI assigned
May 26, 2019
Last updated
May 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X A006262 AR Primary

Addresses

Primary practice location

1709 Cedar Dr
Bryant, AR 72019-6378

Mailing address

1709 Cedar Dr
Bryant, AR 72019-6378
Phone (501) 838-8934

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
I20210323002117 AR Practitioner - Nurse Practitioner 9537576350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient SolutionsGroup PAC ID 5597195206, 31 clinicians

Practice addresses (Care Compare)

5 Medical Park Dr
Suite 304
Benton, AR 72015-3745
Phone (501) 408-2429

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A006262ARMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Solutions CurrentSince Jan 15, 2025 Accepting new patients
Wound Solutions of Nwa, LLC Past Accepting new patients
Wound Solutions of Semo LLC Past Accepting new patients

Locations

5 Medical Park Dr
Benton, AR 72015
Phone (501) 246-3423

5 Medical Park Dr
Ste 304
Benton, AR 72015
Phone (501) 408-2429

Organizations & group practices 3

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": "1558828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558828800000",
    "number": "1235796145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 CEDAR DR",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720196378",
            "telephone_number": "501-838-8934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 CEDAR DR",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720196378",
            "telephone_number": "501-838-8934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOID",
        "first_name": "NICKEY",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-26",
        "last_updated": "2019-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A006262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryant, AR

Sources for this page

Verify at the official NPI Registry.