Individual provider Active NPI

Lorie Oswalt, RN APN MNSC

  • Obstetrics & Gynecology Nurse Practitioner
  • Bentonville, AR
National Provider Identifier
1376717579
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
A03018ANP Issued in AR
Practice address
1200 SE 28TH St
Ste 2
Bentonville, AR 72712-3881
Phone
(479) 271-0005
Fax
(479) 271-0005
NPI assigned
Apr 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X A03018ANP AR Primary

Addresses

Primary practice location

1200 SE 28TH St
Ste 2
Bentonville, AR 72712-3881

Mailing address

1200 SE 28TH St
Ste 2
Bentonville, AR 72712-3881
Phone (479) 271-0005

Other identifiers 1

IdentifierTypeStateIssuer
191390758MedicaidAR

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
I20160701000352 AR Order and Referring Only - Nurse Practitioner 5395037899

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A03018ANPARMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespring Women'S Healthcare PA PastSince Jan 1, 2007 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAHCDA

Organizations & group practices 1

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": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1376717579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SE 28TH ST",
            "address_2": "STE 2",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123881",
            "telephone_number": "479-271-0005",
            "fax_number": "479-271-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SE 28TH ST",
            "address_2": "STE 2",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123881",
            "telephone_number": "479-271-0005",
            "fax_number": "479-271-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSWALT",
        "first_name": "LORIE",
        "name_prefix": "Mrs.",
        "credential": "RN APN MNSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "AR",
            "license": "A03018ANP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191390758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.