NPIMap

Individual provider Active NPI

William Andrew Stevenson IV, M.D.

  • Family Medicine Physician
  • Booneville, AR
National Provider Identifier
1558716738
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-11517 Issued in AR
Practice address
128 Daniel Dr
Booneville, AR 72927-4055
Phone
(479) 675-2455
Fax
(479) 675-4940
NPI assigned
Apr 26, 2016
Last updated
Aug 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-11517 AR Primary

Addresses

Primary practice location

128 Daniel Dr
Booneville, AR 72927-4055

Mailing address

7600 Briarwood Cir
Little Rock, AR 72205-4811
Phone (479) 220-1885

Other identifiers 1

IdentifierTypeStateIssuer
230113001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181003001087 AR Practitioner - Family Practice 0446549083 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital BoonevilleGroup PAC ID 1951530385, shared by 5 NPIs, 13 clinicians

Practice addresses (Care Compare)

128 Daniel Dr
Booneville, AR 72927-4055
Phone (479) 675-2455

880 W Main St
Booneville, AR 72927-3443
Phone (479) 675-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-11517ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Waldron CurrentSince Mar 1, 2023 Accepting new patients
Mercy Hospital Booneville Current Accepting new patients
Mercy Hospital Ozark CurrentSince Nov 5, 2018 Accepting new patients
Mercy Hospital Booneville CurrentSince Jun 4, 2019 Accepting new patients
Mercy Hospital Paris CurrentSince Nov 5, 2018 Accepting new patients
Mercy Hospital Waldron Current Accepting new patients
Mercy Hospital Paris CurrentSince Nov 5, 2018 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Nov 5, 2018 Accepting new patients
Mercy Hospital Ozark CurrentSince Nov 5, 2018 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Nov 5, 2018 Accepting new patients
Mercy Hospital Paris CurrentSince Nov 5, 2018 Accepting new patients
Mercy Hospital Waldron Current Accepting new patients
Mercy Hospital Booneville CurrentSince Jun 4, 2019 Accepting new patients

Locations

128 Daniel Dr
Booneville, AR 72927
Phone (479) 675-2455

880 W Main St
Booneville, AR 72927
Phone (479) 675-2800

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

801 W River St
Ozark, AR 72949
Phone (479) 667-4138

500 E Academy St
Paris, AR 72855
Phone (479) 963-6101

1341 W 6th St
Waldron, AR 72958
Phone (479) 637-2136

Interoperability endpoints

  • Direct secure messaging: wstevenson1013806@directc.mercy.net

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 6

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1558716738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 BRIARWOOD CIR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054811",
            "telephone_number": "479-220-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 DANIEL DR",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729274055",
            "telephone_number": "479-675-2455",
            "fax_number": "479-675-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "WILLIAM",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-11517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230113001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Booneville, AR

Sources for this page

Verify at the official NPI Registry.