Individual provider Active NPI

Michelle Ann Orange, NP

  • Nurse Practitioner
  • Benton, AR
National Provider Identifier
1578190088
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
124417 Issued in AR
Practice address
1 Medical Park Dr
Benton, AR 72015-3353
Phone
(501) 776-6000
NPI assigned
Mar 25, 2020
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 124417 AR
Nurse Practitioner 363L00000X 124417 AR Primary

Addresses

Primary practice location

1 Medical Park Dr
Benton, AR 72015-3353

Mailing address

230 Wagon TRL
Marshall, AR 72650-7002
Phone (870) 496-2004

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
I20201007000484 AR Practitioner - Nurse Practitioner 0840619045 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1 Medical Park Dr
Benton, AR 72015-3353
Phone (501) 776-6025

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124417ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faulkner Emergency Group, PLLC Nurse Practitioner CurrentSince Sep 23, 2023 Accepting new patients
South Arkansas Emergency Physicians, LLP Nurse Practitioner CurrentSince Sep 2, 2020 Accepting new patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Oct 7, 2022 Accepting new patients
Southeast Arkansas Emergency Physicians LLP CurrentSince Sep 23, 2023 Accepting new patients
Southeast Arkansas Emergency Physicians LLP Nurse Practitioner CurrentSince Sep 23, 2023 Accepting new patients
South Arkansas Emergency Physicians LLP Nurse Practitioner Current Accepting new patients

Locations

1 Medical Park Dr
Bryant, AR 72015
Phone (501) 776-6000

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1600 W 40th Ave
Pine Bluff, AR 71603
Phone (870) 541-7100

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

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.

Hospital & facility affiliations 1

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1578190088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 WAGON TRL",
            "city": "MARSHALL",
            "state": "AR",
            "postal_code": "726507002",
            "telephone_number": "870-496-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153353",
            "telephone_number": "501-776-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORANGE",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "124417",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "124417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.