Individual provider Active NPI

Peggy Darty

  • Family Nurse Practitioner
  • Blytheville, AR
National Provider Identifier
1396117453
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004519 Issued in AR
Practice address
1100 Medical Dr
Blytheville, AR 72315-1425
Phone
(870) 563-6504
Fax
(870) 563-7482
NPI assigned
Oct 28, 2015
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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 A004519 AR Primary

Addresses

Primary practice location

1100 Medical Dr
Blytheville, AR 72315-1425

Mailing address

112 E Cheryl St
Osceola, AR 72370-2808
Phone (870) 563-6504

Other identifiers 1

IdentifierTypeStateIssuer
214376758MedicaidAR

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
I20160209001505 AR Practitioner - Nurse Practitioner 2264736461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

602 W Union Ave B
Mississippi County Primary Care Physicians
Osceola, AR 72370-3014
Phone (870) 563-6504

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A004519ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Great River Medical Center Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.yourcareuniverse.net/tenant/3da9ca85-20c5-41a0-bdcd-1c72cbc6cce2
  • Direct secure messaging: peggy.darty.1@15274.direct.athenahealth.com
  • Direct secure messaging: psdarty@yourcarecommunity.org

Organizations & group practices 2

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 2

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": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1396117453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E CHERYL ST",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723702808",
            "telephone_number": "870-563-6504",
            "fax_number": "870-563-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MEDICAL DR",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723151425",
            "telephone_number": "870-563-6504",
            "fax_number": "870-563-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARTY",
        "first_name": "PEGGY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214376758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blytheville, AR

Sources for this page

Verify at the official NPI Registry.