Individual provider Active NPI

Andrea Corinne Dohlman, APRN

  • Adult Health Clinical Nurse Specialist
  • Rogers, AR
National Provider Identifier
1255737359
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
53-76531-031 Issued in KS
Practice address
3333 S Pinnacle Hills Pkwy
Rogers, AR 72758-9100
Phone
(479) 338-4600
Fax
(479) 338-4607
NPI assigned
Nov 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 53-76531-031 KS Primary

Addresses

Primary practice location

3333 S Pinnacle Hills Pkwy
Rogers, AR 72758-9100

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (314) 364-4200

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
I20231116000164 AR Practitioner - Certified Clinical Nurse Specialist (CNS) 3870818198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, 314 clinicians

Practice addresses (Care Compare)

3333 S Pinnacle Hills Pkwy
Suite 300B
Rogers, AR 72758-9000
Phone (479) 338-4600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-76531-031KSMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities CurrentSince Nov 13, 2023 Accepting new patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Nov 13, 2023 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

3333 S Pinnacle Hills Pkwy
Rogers, AR 72758
Phone (479) 338-4600

3333 S Pinnacle Hills Pkwy
Ste 300B
Rogers, AR 72758
Phone (479) 338-4600

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": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1255737359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "314-364-4200",
            "fax_number": "479-338-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S PINNACLE HILLS PKWY",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589100",
            "telephone_number": "479-338-4600",
            "fax_number": "479-338-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHLMAN",
        "first_name": "ANDREA",
        "middle_name": "CORINNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "KS",
            "license": "53-76531-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.