Individual provider Active NPI

Bentlee Katherine Rundell, APRN

  • Family Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1538649231
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A005867 Issued in AR
Practice address
9101 Jenny Lind Rd
Fort Smith, AR 72908-9142
Phone
(479) 322-1901
NPI assigned
Aug 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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 A005867 AR Primary

Addresses

Primary practice location

9101 Jenny Lind Rd
Fort Smith, AR 72908-9142

Mailing address

3519 Watson Rd
Greenwood, AR 72936-9198

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
I20180928002105 AR Practitioner - Nurse Practitioner 5092066167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9101 Jenny Lind Rd
Fort Smith, AR 72908-9142
Phone (479) 274-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005867ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Apr 22, 2019 Accepting new patients
Icp Arkansas Aco Billing LLC CurrentSince May 7, 2021 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Apr 22, 2019 Accepting new patients
Icarepro of Texas, PA Past Accepting new patients

Locations

6801 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-6000

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

9101 Jenny Lind Rd
Fort Smith, AR 72908
Phone (479) 274-6000

3700 Cliff Dr
Fort Smith, AR 72903
Phone (479) 259-9286

8050 Counts Massie Rd
Ste B
Maumelle, AR 72113
Phone (501) 492-0099

Interoperability endpoints

  • Direct secure messaging: bcothern508124@directc.mercy.net

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 3

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": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1538649231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3519 WATSON RD",
            "city": "GREENWOOD",
            "state": "AR",
            "postal_code": "729369198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 JENNY LIND RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729089142",
            "telephone_number": "479-322-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNDELL",
        "first_name": "BENTLEE",
        "middle_name": "KATHERINE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.