Individual provider Active NPI

Tracy Michelle Pillow, RN

  • Registered Nurse
  • Forrest City, AR
National Provider Identifier
1588093074
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R63570 Issued in AR
Practice address
3998 Highway 1 N
Forrest City, AR 72335-7637
Phone
(870) 633-2120
Fax
(870) 633-1738
NPI assigned
Nov 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R63570 AR Primary

Addresses

Primary practice location

3998 Highway 1 N
Forrest City, AR 72335-7637

Mailing address

3998 Highway 1 N
Forrest City, AR 72335-7637
Phone (870) 633-2120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R63570ARMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1588093074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 HIGHWAY 1 N",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723357637",
            "telephone_number": "870-633-2120",
            "fax_number": "870-633-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 HIGHWAY 1 N",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723357637",
            "telephone_number": "870-633-2120",
            "fax_number": "870-633-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLOW",
        "first_name": "TRACY",
        "middle_name": "MICHELLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R63570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forrest City, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.