Individual provider Active NPI

Garry M Melton, CRNA

  • Certified Registered Nurse Anesthetist
  • Harrison, AR
National Provider Identifier
1477592368
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C00178 Issued in AR
Practice address
620 N Willow St
Harrison, AR 72601-2994
Phone
(570) 424-7070
Fax
(870) 424-6616
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X C00178 AR Primary

Addresses

Primary practice location

620 N Willow St
Harrison, AR 72601-2994

Mailing address

PO Box 432
Mountain Home, AR 72654-0432
Phone (870) 424-7070

Other identifiers 1

IdentifierTypeStateIssuer
101294701MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
Chris W Taylor, M.D., P.a. Nurse Anesthetist, Certified Registered CurrentSince Jan 15, 2016 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
Chris Taylor Cosmetics, P.a. Current Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
Premier Anesthesia of Arkansas Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince May 10, 2014 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Sep 1, 2011 Accepting new patients
North Arkansas Regional Medical Center PastSince Jan 1, 1990 Accepting new patients
Nurse Anesthesia of North Carolina, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
North Arkansas Regional Medical Center PastSince Jan 1, 1990 Accepting new patients
Ozarks Medical Center Past Accepting new patients
North Arkansas Regional Medical Center PastSince Jan 1, 1990 Accepting new patients
North Arkansas Regional Medical Center PastSince Jan 1, 1990 Accepting new patients
Rebsamen Anesthesia Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Southwestern Physician Services LLC Past Accepting new patients

Locations

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

1425 Rock Springs Rd
Harrison, AR 72601
Phone (870) 741-1616

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

Organizations & group practices 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1477592368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726540432",
            "telephone_number": "870-424-7070",
            "fax_number": "870-424-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N WILLOW ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012994",
            "telephone_number": "570-424-7070",
            "fax_number": "870-424-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTON",
        "first_name": "GARRY",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C00178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101294701",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.