Individual provider Active NPI

Heather Mutters, APRN

  • Family Medicine Physician
  • Van Buren, AR
National Provider Identifier
1245733930
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
116348 Issued in AR
Practice address
109 Pointer TRL W
Van Buren, AR 72956-2236
Phone
(479) 922-2222
Fax
(479) 922-2227
NPI assigned
Mar 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 116348 AR Primary

Addresses

Primary practice location

109 Pointer TRL W
Van Buren, AR 72956-2236

Mailing address

109 Pointer TRL W
Van Buren, AR 72956-2236
Phone (479) 922-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20180510001993 OK Practitioner - Nurse Practitioner 2769746114 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
116348ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pointer Trail Family Clinic PLLC Family Medicine CurrentSince Apr 28, 2024 Accepting new patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Jan 27, 2020 Accepting new patients
Douglas Carlson DO, PA PastSince Apr 28, 2024 Accepting new patients

Locations

109 Pointer Trl W
Van Buren, AR 72956
Phone (479) 922-2222

10914 Hefner Pointe Dr
Ste 202
Oklahoma City, OK 73120
Phone (405) 815-6840

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1245733930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 POINTER TRL W",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729562236",
            "telephone_number": "479-922-2222",
            "fax_number": "479-922-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 POINTER TRL W",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729562236",
            "telephone_number": "479-922-2222",
            "fax_number": "479-922-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTTERS",
        "first_name": "HEATHER",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "116348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Buren, AR

Sources for this page

Verify at the official NPI Registry.