Individual provider Active NPI

Lance Michael Harrell, APN - BC

  • Family Nurse Practitioner
  • West Memphis, AR
National Provider Identifier
1447407671
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A03149 Issued in AR
Practice address
2201 Horizon Dr.
Ste. 4
West Memphis, AR 72301-0000
Phone
(870) 732-0332
Fax
(870) 732-3078
NPI assigned
Aug 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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 A03149 AR Primary

Addresses

Primary practice location

2201 Horizon Dr.
Ste. 4
West Memphis, AR 72301-0000

Mailing address

2201 Horizon Dr.
Ste. 4
West Memphis, AR 72301-0000
Phone (870) 732-0332

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
I20081007000837 AR Practitioner - Nurse Practitioner 4385712033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Coast to Coast Medical LLCGroup PAC ID 3274606314, 4 clinicians

Practice addresses (Care Compare)

710 N Missouri St
West Memphis, AR 72301-3150
Phone (870) 732-0332

Hospital & facility affiliations

  • Elite Home Health Home health agency, Marion, AR, CCN 047122
  • Baptist Memorial Hospital-Crittenden, Inc Hospital, West Memphis, AR, CCN 040156
  • Crossridge Community Hospital Hospital, Wynne, AR, CCN 041307
  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020

Merit-based Incentive Payment System (MIPS)

Final score
28.84 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
74.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A03149ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coast to Coast Medical, LLC CurrentSince Jul 30, 2008 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Tyler Emergency Physicians Past Accepting new patients

Locations

710 N Missouri St
West Memphis, AR 72301
Phone (870) 394-9149

2201 Horizan Rd
Ste 4
West Memphis, AR 72301
Phone (870) 732-0332

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1447407671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 HORIZON DR.",
            "address_2": "STE. 4",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723010000",
            "telephone_number": "870-732-0332",
            "fax_number": "870-732-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HORIZON DR.",
            "address_2": "STE. 4",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723010000",
            "telephone_number": "870-732-0332",
            "fax_number": "870-732-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "LANCE",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "APN - BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A03149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Memphis, AR

Sources for this page

Verify at the official NPI Registry.