NPIMap

Individual provider Active NPI

Shelley Payne, APRN

  • Nurse Practitioner
  • Bryant, AR
National Provider Identifier
1306830468
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A01505 Issued in AR
Practice address
4411 Highway 5 N
Bryant, AR 72022-7005
Phone
(501) 847-0289
Fax
(501) 847-8748
NPI assigned
Sep 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A01505 AR Primary

Addresses

Primary practice location

4411 Highway 5 N
Bryant, AR 72022-7005

Mailing address

4411 Highway 5 N
Bryant, AR 72022-7005
Phone (501) 847-0289

Other identifiers 3

IdentifierTypeStateIssuer
162274758MedicaidAR
5Y394OtherBCBS
A01505OtherARCHAMPUS

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
I20050718000531 AR Practitioner - Nurse Practitioner 1254368657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

4411 Hwy 5 N
Bryant, AR 72022-7005
Phone (501) 847-0289

Hospital & facility affiliations

  • Saline Memorial Home Health Home health agency, Bryant, AR, CCN 047043
  • Elite Home Health Home health agency, Hot Springs, AR, CCN 047151
  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114
  • Saline Memorial Hospital Hospital, Benton, AR, CCN 040084
  • Baptist Health Medical Center-Hot Springs County Hospital, Malvern, AR, CCN 040076
  • Baptist Health Rehabilitation Institute Inpatient rehabilitation facility, Little Rock, AR, CCN 043026

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Jul 1, 2012 Accepting new patients
Arkansas Health Group CurrentSince Jul 1, 2012 Accepting new patients
Shawn Purifoy, M.D., P.a. PastSince May 18, 2010 Accepting new patients
Arkansas Health Group Past Accepting new patients
Little Rock Cardiology Clinic, PA Past Accepting new patients
Richard D Johns, M.D., P.a. Past Accepting new patients

Locations

4411 Highway 5 N
Bryant, AR 72022
Phone (501) 847-0289

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

Interoperability endpoints

  • Direct secure messaging: spayne4574@direct.baptist-healthar.org

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1306830468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 HIGHWAY 5 N",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720227005",
            "telephone_number": "501-847-0289",
            "fax_number": "501-847-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 HIGHWAY 5 N",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720227005",
            "telephone_number": "501-847-0289",
            "fax_number": "501-847-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "SHELLEY",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-06",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A01505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162274758",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5Y394",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "A01505",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryant, AR

Sources for this page

Verify at the official NPI Registry.