Donna Matlock, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AO1582 Issued in AR

Practice address

2012 S Promenade Blvd
Rogers, AR 72758

Phone

(479) 616-1485

Fax

(479) 239-0536

NPI assigned

May 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Watkins Family Health & Counseling, Inc.

  • Family Nurse Practitioner
  • Fayetteville, AR
  • NPI 1346789948
  Medicare reassignment
• Arkansas Em-I Byrne Medical Services P.a.

  • Emergency Medicine Physician
  • Fayetteville, AR
  • NPI 1023310448
  NPD (past)
• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  NPD (past)
• Northwest Arkansas Gastroenterology Clinic PA

  • Specialist
  • Lowell, AR
  • NPI 1770634065
  NPD (past)
• Southeastern Emergency Services P C

  • Nurse Practitioner
  • Athens, TN
  • NPI 1669414264
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1295780690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 S PROMENADE BLVD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589073",
            "telephone_number": "479-616-1485",
            "fax_number": "479-239-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 S PROMENADE BLVD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-616-1485",
            "fax_number": "479-239-0536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3409 Elm Springs Rd.",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "72762",
            "country_code": "US",
            "telephone_number": "479-927-2100 x5251",
            "fax_number": "479-927-2211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3409 Elm Springs Rd.",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "72762",
            "country_code": "US",
            "telephone_number": "479-927-2100 x5251",
            "fax_number": "479-927-2211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATLOCK",
        "first_name": "DONNA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "AO1582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426270807",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148362758",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00378001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frida Mateo Rodriguez, RBT
• Maternity Center of Northwest Arkansas LLC
• Borian Boris Matinchev, M.D.
• Maria Del Carmen Matinchev, M.D.
• Julie Matkins, LPTA
• Robert Joe Matlock, DDS
• Matthew B. Harrison, DDS, PA
• Meaghan Victoria Maurya, BCBA
• Maximum Performance Chiropractic, Inc.
• Holly D McAdams, APRN

• Family Nurse Practitioner in Rogers, AR
• Providers in Rogers, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.