Active NPI
Chandra Mathis, FNP-C
- Primary Care Nurse Practitioner
- Barling, AR
National Provider Identifier
1548718125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- A004908
- Practice address
- 1200 Fort St
Barling, AR 72923 - Phone
- (479) 763-1511
- Fax
- (479) 763-1545
- NPI assigned
- Sep 13, 2016
- Last updated
- Oct 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | A004908 | AR | Primary |
Addresses
Primary practice location
1200 Fort St
Barling, AR 72923
Mailing address
1200 Fort St Ste a
Barling, AR 72923-2013
Phone (479) 763-1511
Other practice location 1
12300 Highway 71 S
Suite A
Fort Smith, AR 72916-9133
Phone (479) 755-6595
Other practice location 2
7001 Rogers Ave
Fort Smith, AR 72903-4073
Phone (479) 314-7490
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 221472758 | Medicaid | AR |
Other names 1
- Chandra D Myers
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1202 NE McClain Rd
BLDG 7
Bentonville, AR 72712-3875
Phone (203) 901-2493
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A004908 | AR | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Fort Smith Communities | Current | Accepting new patients | |
| Mercy Clinic Fort Smith Communities | Multi-Specialty | Current | Accepting new patients |
| Healthmax Center LLC | Multi-Specialty | Past | Accepting new patients |
| St Marys Physician Services, LLC | Past | Accepting new patients |
Locations
7001 Rogers Ave
Fort Smith, AR 72903
Phone (479) 478-3510
7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Alma, AR
- NPI 1811100910
-
- Nurse Practitioner
- Bentonville, AR
- NPI 1992553028
-
- Endocrinology, Diabetes & Metabolism Physician
- Fort Smith, AR
- NPI 1790258002
-
- Multi-Specialty Clinic/Center
- Fort Smith, AR
- NPI 1902073620
-
dba Cardiology Associates of North Central Arkansas
- Interventional Cardiology Physician
- Russellville, AR
- NPI 1720356207
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Smith, AR
- NPI 1568433480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538611200000",
"number": "1548718125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 FORT ST STE A",
"city": "BARLING",
"state": "AR",
"postal_code": "729232013",
"telephone_number": "479-763-1511",
"fax_number": "479-763-1545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 FORT ST",
"city": "BARLING",
"state": "AR",
"postal_code": "72923",
"telephone_number": "479-763-1511",
"fax_number": "479-763-1545"
}
],
"practiceLocations": [
{
"address_1": "12300 Highway 71 S",
"address_2": "Suite A",
"address_purpose": "LOCATION",
"city": "Fort Smith",
"state": "AR",
"postal_code": "729169133",
"country_code": "US",
"telephone_number": "479-755-6595",
"fax_number": "479-755-6596",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7001 Rogers Ave",
"address_purpose": "LOCATION",
"city": "Fort Smith",
"state": "AR",
"postal_code": "729034073",
"country_code": "US",
"telephone_number": "479-314-7490",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATHIS",
"first_name": "CHANDRA",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-13",
"last_updated": "2018-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "AR",
"license": "A004908",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "221472758",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHANDRA",
"last_name": "MYERS",
"middle_name": "D",
"credential": "FNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Barling, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.