Individual provider Active NPI

Brenna Leanne Fitzgerald, APRN

  • Nurse Practitioner
  • North Little Rock, AR
National Provider Identifier
1437337110
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A03058 Issued in AR
Practice address
2501 Crestwood Rd Ste 204
North Little Rock, AR 72116-7616
Phone
(501) 819-0901
Fax
(501) 492-6478
NPI assigned
Feb 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A03058 AR Primary

Addresses

Primary practice location

2501 Crestwood Rd Ste 204
North Little Rock, AR 72116-7616

Mailing address

2501 Crestwood Rd Ste 204
North Little Rock, AR 72116-7616
Phone (501) 819-0901

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
I20150522001871 AR Practitioner - Nurse Practitioner 3173843638 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kathryn Chenault, MD, PAGroup PAC ID 7315108792, 2 clinicians

Practice addresses (Care Compare)

2501 Crestwood Rd
Suite 204
North Little Rock, AR 72116-7616
Phone (501) 819-0901

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A03058ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kathryn Chenault, MD, PA CurrentSince Apr 11, 2015 Accepting new patients
M.S. Clinc of Arkansas, LLC CurrentSince Nov 22, 2016 Accepting new patients

Locations

2501 Crestwood Rd
Ste 204
North Little Rock, AR 72116
Phone (501) 753-4132

2215 Wildwood Ave
Ste 200
Sherwood, AR 72120
Phone (501) 819-0901

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1437337110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CRESTWOOD RD STE 204",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167616",
            "telephone_number": "501-819-0901",
            "fax_number": "501-492-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CRESTWOOD RD STE 204",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167616",
            "telephone_number": "501-819-0901",
            "fax_number": "501-492-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "BRENNA",
        "middle_name": "LEANNE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A03058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.