Individual provider Active NPI

Mishann Luedders-East, APRN-CNP

  • Gerontology Nurse Practitioner
  • Hardy, AR
National Provider Identifier
1366258774
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
120637 Issued in AR
Practice address
4196 Highway 62 412 Ste a
Hardy, AR 72542-8002
Phone
(870) 895-2015
NPI assigned
Dec 10, 2024
Last updated
Dec 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 120637 AR Primary

Addresses

Primary practice location

4196 Highway 62 412 Ste a
Hardy, AR 72542-8002

Mailing address

4196 Highway 62 412 Ste a
Hardy, AR 72542-8002
Phone (870) 895-2015

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
I20250103000028 AR Practitioner - Nurse Practitioner 6608303672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16723 Hwy 62
Garfield, AR 72732-7007
Phone (870) 219-7706

451 Phillips St
West Fork, AR 72774-2813
Phone (479) 294-6085

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Clinic Arkansas LLC CurrentSince Jan 2, 2025 Accepting new patients
Access Medical Clinic Arkansas LLC Current Accepting new patients
Access Medical Clinic Arkansas LLC CurrentSince Jan 2, 2025 Accepting new patients

Locations

16723 Highway 62
Garfield, AR 72732
Phone (870) 219-7706

4196 Highway 62 412
#A
Hardy, AR 72542
Phone (870) 856-2100

451 Phillips St
West Fork, AR 72774
Phone (479) 294-6085

Interoperability endpoints

  • Direct secure messaging: mishann.luedders-east.1@15024.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1733788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1366258774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4196 HIGHWAY 62 412 STE A",
            "city": "HARDY",
            "state": "AR",
            "postal_code": "725428002",
            "telephone_number": "870-895-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4196 HIGHWAY 62 412 STE A",
            "city": "HARDY",
            "state": "AR",
            "postal_code": "725428002",
            "telephone_number": "870-895-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEDDERS-EAST",
        "first_name": "MISHANN",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "120637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hardy, AR

Sources for this page

Verify at the official NPI Registry.