Individual provider Active NPI

Kathleen M Maples, APN

  • Nurse Practitioner
  • West Memphis, AR
National Provider Identifier
1245307586
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A02928 Issued in AR
Practice address
200 W Tyler Ave
West Memphis, AR 72301-4223
Phone
(501) 658-2718
Fax
(501) 724-3305
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A02928 AR Primary

Addresses

Primary practice location

200 W Tyler Ave
West Memphis, AR 72301-4223

Mailing address

485 Hwy 124
PO Box 153
Pangburn, AR 72121
Phone (501) 658-2718

Other identifiers 1

IdentifierTypeStateIssuer
164961758MedicaidAR

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
I20080204000207 AR Practitioner - Nurse Practitioner 5799872685 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
White County Medical Center Current Accepting new patients
White County Medical Center CurrentSince Jun 1, 2014 Accepting new patients
White County Medical Center CurrentSince Jun 1, 2014 Accepting new patients
Tennessee Emergency Physicians, PLLC PastSince Feb 9, 2020 Accepting new patients
White River Rural Health Center, Inc. Past Accepting new patients
Tyler Emergency Physicians Past Accepting new patients
Arcare Past Accepting new patients
White River Rural Health Center, Inc. Past Accepting new patients

Locations

2725 Highway 25B
Heber Springs, AR 72543
Phone (501) 362-5800

3214 E Race Ave
Searcy, AR 72143
Phone (501) 268-6121

2902 E Race Ave
Searcy, AR 72143
Phone (501) 236-0225

2900 Hawkins Dr
Searcy, AR 72143
Phone (501) 278-2800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 8

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1245307586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 HWY 124",
            "address_2": "PO BOX 153",
            "city": "PANGBURN",
            "state": "AR",
            "postal_code": "72121",
            "telephone_number": "501-658-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W TYLER AVE",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014223",
            "telephone_number": "501-658-2718",
            "fax_number": "501-724-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAPLES",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A02928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164961758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Memphis, AR

Sources for this page

Verify at the official NPI Registry.