Khem Nouansavane, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

A004913 Issued in AR

Practice address

7001 Rogers Ave Ste 401a
Fort Smith, AR 72903-4034

Phone

(479) 314-4650

Fax

(479) 452-4650

NPI assigned

Oct 19, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, shared by 4 NPIs, 361 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mercy Clinic Fort Smith Communities

  • Medical Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1023346202
  Medicare reassignment NPD
• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment NPD
• Mercy Clinic Fort Smith Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Smith, AR
  • NPI 1790258002
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1497206924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 ROGERS AVE STE 401A",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034034",
            "telephone_number": "479-314-4650",
            "fax_number": "479-452-9459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 ROGERS AVE STE 401A",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034034",
            "telephone_number": "479-314-4650",
            "fax_number": "479-452-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOUANSAVANE",
        "first_name": "KHEM",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-19",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A004913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy L North-Flanagan, APRN
• Northport Health Services of Arkansas, LLC
• Northport Health Services of Arkansas, LLC
• Northwest Arkansas Anesthesia Services LLC
• Chansamorn Morn Nouansavane, MD
• Kaitlin Victoria Novoa, LMT
• Robert L Nowlin, MD
• Gina Danley Null, APN, MSN, ANP-BC,OCN
• Lauren Elise Null
• Aaron Antonio Nunez, M.D.

• Acute Care Nurse Practitioner in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Acute Care Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.