NPIMap

Individual provider Active NPI

Stephanie Ann Moser, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Southside, AR
National Provider Identifier
1265058804
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
125283 Issued in AR
Practice address
36 Red Bud Dr
Southside, AR 72501-8049
Phone
(879) 262-9302
NPI assigned
Jun 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 125283 AR Primary

Addresses

Primary practice location

36 Red Bud Dr
Southside, AR 72501-8049

Mailing address

36 Red Bud Dr
Southside, AR 72501-8049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230208002836 AR Practitioner - Nurse Practitioner 4486049061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bradley Bibb MD PLLC 71 clinicians

Practice addresses (Care Compare)

4196 Hwy 62 412
Hardy, AR 72542-8002
Phone (870) 994-7301

Hospital & facility affiliations

  • White River Medical Center Hospital, Batesville, AR, CCN 040119

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Mississippi, PLLC CurrentSince Aug 1, 2024 Accepting new patients
Bradley Bibb MD PLLC CurrentSince Jul 1, 2025 Accepting new patients
Bradley Bibb MD PLLC CurrentSince Jul 1, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Aug 1, 2024 Accepting new patients
Bradley Bibb MD PLLC Current Accepting new patients
Icarepro of Texas, PA Past Accepting new patients
Bradley Bibb MD PLLC Past Accepting new patients
Bradley Bibb MD PLLC Past Accepting new patients

Locations

49 Highway 62 412
Ste 412
Ash Flat, AR 72513

49 Highway 62 412
Ash Flat, AR 72513
Phone (573) 718-2570

4196 Highway 62 412
#A
Hardy, AR 72542
Phone (870) 856-2100

1020 Highway 62 E
Mountain Home, AR 72653
Phone (870) 337-2171

3809 E 9th St
Ste 15
Texarkana, AR 71854
Phone (870) 621-0080

Interoperability endpoints

  • Direct secure messaging: stephanie.moser.1@2424.direct.athenahealth.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1265058804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 RED BUD DR",
            "city": "SOUTHSIDE",
            "state": "AR",
            "postal_code": "725018049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 RED BUD DR",
            "city": "SOUTHSIDE",
            "state": "AR",
            "postal_code": "725018049",
            "telephone_number": "879-262-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "125283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southside, AR

Sources for this page

Verify at the official NPI Registry.