Individual provider Active NPI

Shyanne Faith Price, PA

  • Physician Assistant
  • North Little Rock, AR
National Provider Identifier
1447904503
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1045 Issued in AR
Practice address
4020 Richards Rd Ste a
North Little Rock, AR 72117-2744
Phone
(844) 215-0731
Fax
(501) 404-7789
NPI assigned
Feb 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1045 AR Primary

Addresses

Primary practice location

4020 Richards Rd Ste a
North Little Rock, AR 72117-2744

Mailing address

3321 S Bowman Rd Apt 617
Little Rock, AR 72211-4675
Phone (501) 712-2571

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
I20220411000281 AR Practitioner - Physician Assistant 1052707551 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, 314 clinicians

Practice addresses (Care Compare)

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 636-0200

3101 SE 14TH St
Bentonville, AR 72712-4900
Phone (479) 631-2100

Hospital & facility affiliations

  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1045ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Treatment Centers of America, PLLC CurrentSince Jan 13, 2022 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Aug 1, 2024 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Aug 1, 2024 Accepting new patients

Locations

1215 Sidney St
Batesville, AR 72501
Phone (870) 262-1541

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

108 N Shackleford Rd
Little Rock, AR 72211
Phone (501) 346-8116

4020 Richards Rd
Ste A
North Little Rock, AR 72117
Phone (501) 900-8763

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1447904503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 S BOWMAN RD APT 617",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114675",
            "telephone_number": "501-712-2571",
            "fax_number": "501-404-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 RICHARDS RD STE A",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172744",
            "telephone_number": "844-215-0731",
            "fax_number": "501-404-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "SHYANNE",
        "middle_name": "FAITH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA1045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.