Individual provider Active NPI

Erin Elizabeth Kistner, APRN

  • Family Nurse Practitioner
  • Rogers, AR
National Provider Identifier
1356015465
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
214496 Issued in AR
Practice address
2708 S Rife Medical LN Ste 220
Rogers, AR 72758-1456
Phone
(479) 338-4400
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 214496 AR Primary

Addresses

Primary practice location

2708 S Rife Medical LN Ste 220
Rogers, AR 72758-1456

Mailing address

2708 S Rife Medical LN Ste 220
Rogers, AR 72758-1456
Phone (479) 338-4400

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
I20210920002413 AR Practitioner - Nurse Practitioner 9335546233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2708 S Rife Medical LN
Suite 220
Rogers, AR 72758-1456
Phone (479) 338-4400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214496ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities CurrentSince Sep 19, 2021 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Sep 19, 2021 Accepting new patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

2708 S Rife Medical Ln
Ste 220
Rogers, AR 72758
Phone (479) 338-4400

Interoperability endpoints

  • Direct secure messaging: ekistner953972@directc.mercy.net

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.

Hospital & facility affiliations 1

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": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1356015465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 S RIFE MEDICAL LN STE 220",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581456",
            "telephone_number": "479-338-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 S RIFE MEDICAL LN STE 220",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581456",
            "telephone_number": "479-338-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTNER",
        "first_name": "ERIN",
        "middle_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "214496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.