Individual provider Active NPI

Joni L. Carmack, M.D.

  • Emergency Medicine Physician
  • Van Buren, AR
National Provider Identifier
1386623056
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-3151 Issued in AR
Practice address
East Main & South 20TH Street
Van Buren, AR 72957
Phone
(479) 474-3401
Fax
(479) 471-4388
NPI assigned
Jan 11, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-3151 AR Primary

Addresses

Primary practice location

East Main & South 20TH Street
Van Buren, AR 72957

Mailing address

1004 E Bryan Ave
Sapulpa, OK 74066-4513
Phone (918) 748-7557

Other identifiers 2

IdentifierTypeStateIssuer
5M145OtherARBLUECROSS BLUESHIELD
146400001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140925001745 OK Practitioner - Emergency Medicine 3375510266 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-3151ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Sep 1, 2014 Accepting new patients
St. John Physicians, Inc. Emergency Medicine CurrentSince Sep 1, 2014 Accepting new patients
Nes Western Arkansas, Inc Past Accepting new patients
Nes Arkansas, Inc. Emergency Medicine Past Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386623056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 E BRYAN AVE",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740664513",
            "telephone_number": "918-748-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST MAIN & SOUTH 20TH STREET",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "72957",
            "telephone_number": "479-474-3401",
            "fax_number": "479-471-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMACK",
        "first_name": "JONI",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-3151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "5M145",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146400001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Buren, AR

Sources for this page

Verify at the official NPI Registry.