Individual provider Active NPI

Lesli Ashten Anderson, APRN

  • Family Medicine Physician
  • Wynne, AR
National Provider Identifier
1285164145
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A005181 Issued in AR
Practice address
411 Falls Blvd S
Wynne, AR 72396-3501
Phone
(870) 238-3261
Fax
(870) 238-3115
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 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 A005181 AR Primary

Addresses

Primary practice location

411 Falls Blvd S
Wynne, AR 72396-3501

Mailing address

2 Village Creek Dr
Newport, AR 72112-3065

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
I20170718000417 AR Practitioner - Nurse Practitioner 0244500627 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005181ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Health - Newport Current Accepting new patients

Organizations & group practices 2

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": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1285164145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 VILLAGE CREEK DR",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721123065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963501",
            "telephone_number": "870-238-3261",
            "fax_number": "870-238-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LESLI",
        "middle_name": "ASHTEN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "A005181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynne, AR

Sources for this page

Verify at the official NPI Registry.