Individual provider Active NPI

Amy M Bennett, APN

  • Family Nurse Practitioner
  • Malvern, AR
National Provider Identifier
1467758904
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ATP000330 Issued in AR
Practice address
1002 Schneider Dr Ste 104
Malvern, AR 72104-4823
Phone
(501) 332-7981
Fax
(501) 337-9964
NPI assigned
Feb 1, 2011
Last updated
Mar 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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 ATP000330 AR Primary

Addresses

Primary practice location

1002 Schneider Dr Ste 104
Malvern, AR 72104-4823

Mailing address

506 Little Creek Cut Off Rd
Sheridan, AR 72150-7798
Phone (501) 332-7981

Other identifiers 1

IdentifierTypeStateIssuer
185941758MedicaidAR

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
I20110727000237 AR Practitioner - Nurse Practitioner 9739357245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1707 Airport Rd
Hot Springs, AR 71913-7949
Phone (501) 767-6200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ATP000330ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CHI St. Vincent Medical Group Hot Springs CurrentSince May 7, 2018 Accepting new patients
Hot Springs MRI Center PastSince May 7, 2018 Accepting new patients

Locations

234 E Broadway
Glenwood, AR 71943
Phone (870) 356-4821

1 Mercy Ln
Ste 301
Hot Springs, AR 71913
Phone (501) 622-6556

1 Mercy Ln
Ste 201
Hot Springs National Park, AR 71913
Phone (501) 321-2229

1707 Airport Rd
Hot Springs National Park, AR 71913
Phone (501) 312-2293

320 Luzerne St
Mount Ida, AR 71957
Phone (870) 867-2175

319 E 13th St
Murfreesboro, AR 71958
Phone (870) 285-3118

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 8

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": "1296518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1467758904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 LITTLE CREEK CUT OFF RD",
            "city": "SHERIDAN",
            "state": "AR",
            "postal_code": "721507798",
            "telephone_number": "501-332-7981",
            "fax_number": "501-337-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 SCHNEIDER DR STE 104",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044823",
            "telephone_number": "501-332-7981",
            "fax_number": "501-337-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-01",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "ATP000330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185941758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.