Active NPI
Hershel Lynn Mayo, APN
- Family Nurse Practitioner
- Harrison, AR
National Provider Identifier
1518933167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A01349
- Practice address
- 715 W Sherman Ave
Suite G
Harrison, AR 72601-2743 - Phone
- (870) 741-8247
- Fax
- (870) 741-3933
- NPI assigned
- Feb 24, 2006
- Last updated
- Dec 1, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A01349 | AR | Primary |
Addresses
Primary practice location
715 W Sherman Ave
Suite G
Harrison, AR 72601-2743
Mailing address
PO Box 1597
Harrison, AR 72602-1597
Phone (870) 741-8247
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 136698762 | Medicaid | AR |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 705 | MT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259625600000",
"number": "1518933167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1597",
"city": "HARRISON",
"state": "AR",
"postal_code": "726021597",
"telephone_number": "870-741-8247",
"fax_number": "870-741-3933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 W SHERMAN AVE",
"address_2": "SUITE G",
"city": "HARRISON",
"state": "AR",
"postal_code": "726012743",
"telephone_number": "870-741-8247",
"fax_number": "870-741-3933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYO",
"first_name": "HERSHEL",
"middle_name": "LYNN",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-24",
"last_updated": "2009-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A01349",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "136698762",
"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 Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.