Individual provider Active NPI

Joanne K Mazander, ANP

  • Adult Health Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1306830575
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A01342 Issued in AR
Practice address
9500 Kanis Rd
Suite 101
Little Rock, AR 72205-6324
Phone
(501) 202-1902
Fax
(501) 202-1512
NPI assigned
Sep 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A01342 AR Primary

Addresses

Primary practice location

9500 Kanis Rd
Suite 101
Little Rock, AR 72205-6324

Mailing address

9500 Kanis Rd
Suite 101
Little Rock, AR 72205-6324
Phone (501) 202-1902

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
I20031111000773 AR Practitioner - Nurse Practitioner 5799697116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4509 E McCain Blvd
North Little Rock, AR 72117-2902

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Little Rock Cardiology Clinic, PA Past Accepting new patients
Timothy R Cook MD Past Accepting new patients

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": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1306830575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 KANIS RD",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056324",
            "telephone_number": "501-202-1902",
            "fax_number": "501-202-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 KANIS RD",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056324",
            "telephone_number": "501-202-1902",
            "fax_number": "501-202-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZANDER",
        "first_name": "JOANNE",
        "middle_name": "K",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "A01342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.