Individual provider Active NPI

Tawni Sue Glander, APRN

  • Family Medicine Physician
  • Fort Smith, AR
National Provider Identifier
1558992149
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
122834 Issued in AR
Practice address
7800 Dallas St
Fort Smith, AR 72903-4278
Phone
(479) 314-4940
NPI assigned
Jan 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 102811 OK
Family Medicine Physician 207Q00000X 122834 AR Primary

Addresses

Primary practice location

7800 Dallas St
Fort Smith, AR 72903-4278

Mailing address

1339 Willowbrook Cir
Fort Smith, AR 72908-9077

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL n/a

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200312001967 AR Practitioner - Nurse Practitioner 2961830534 Reassigns benefits to 4 organizations
I20200402000544 OK Practitioner - Nurse Practitioner 2961830534 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102811OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Mar 23, 2020 Accepting new patients
Mercy Hospital Paris CurrentSince Mar 23, 2020 Accepting new patients
Mercy Hospital Paris Current Accepting new patients
Mercy Hospital Waldron CurrentSince Mar 23, 2020 Accepting new patients
Mercy Hospital Paris CurrentSince Mar 23, 2020 Accepting new patients
Mercy Hospital Booneville CurrentSince Mar 23, 2020 Accepting new patients
Mercy Hospital Waldron CurrentSince Mar 23, 2020 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Mar 23, 2020 Accepting new patients
Mercy Hospital Booneville CurrentSince Mar 23, 2020 Accepting new patients

Locations

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

301 S E St
Fort Smith, AR 72901
Phone (479) 242-4191

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

7800 Dallas St
Fort Smith, AR 72903
Phone (479) 259-9286

351 E Priddy St
Magazine, AR 72943
Phone (479) 969-8640

100 N Walnut Ave
#A
Mansfield, AR 72944
Phone (479) 928-4404

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

303 S 5th St
Paris, AR 72855
Phone (479) 314-3154

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

1015 E Choctaw Ave
Sallisaw, OK 74955
Phone (918) 774-0034

Interoperability endpoints

  • Direct secure messaging: tmings727556@directc.mercy.net

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1558992149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 WILLOWBROOK CIR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729089077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 DALLAS ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034278",
            "telephone_number": "479-314-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLANDER",
        "first_name": "TAWNI",
        "middle_name": "SUE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "102811",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "122834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "address_1": "7800 Dallas St",
            "city": "Fort Smith",
            "state": "AR",
            "country_code": "US",
            "postal_code": "729034278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.