Erin Edgmon, APRN
Individual provider Active NPI Family Nurse Practitioner · Jasper, AR
NPI 1346856366 · NPPES record last updated Jul 22, 2021
Key facts
- NPI
- 1346856366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 212623 (AR)
- Practice address
- Boston Mountain Rural Health Center Inc.
609 W Clark St
Jasper, AR 72641-0130 - Phone
- (870) 446-2225
- Fax
- (870) 446-2227
- NPI assigned
- Sep 16, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201030000742 | AR | Practitioner - Nurse Practitioner | 1658781737 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington Regional Medical System | Current |
Accepting new patients | |
| Washington Regional Medical System | Current |
Accepting new patients | |
| Washington Regional Medical System | Current |
Accepting new patients | |
| Washington Regional Medical System | Current | Accepting new patients |
Locations
3 E Appleby Rd
Ste 101
Fayetteville, AR 72703
Phone (479) 404-1010
114 E Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 463-2597
715 W Sherman Ave
Ste G
Harrison, AR 72601
Phone (870) 741-8247
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 212623 | AR | Yes |
Addresses
Primary practice location
Boston Mountain Rural Health Center Inc.
609 W Clark St
Jasper, AR 72641-0130
Mailing address
PO Box 1060
Marshall, AR 72650-1060
Phone (870) 448-5733
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 254276758 | Medicaid | AR |
Other providers in Jasper, AR
- B & H Operations LLC
- Chrissie L Bell
- Boston Mountain Rural Health Center Inc.
- Coats Chiropractic Clinic PA
- Coats Chiropractic Clinic PA
- Nicole Fairchild
- Health Resources of Arkansas, Inc.
- Jasper Pharmacy Inc
- James B Justice
- Helen R Kling
All providers in Jasper, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.