Individual provider Active NPI

Sherry G McIntosh, APRN

  • Adult Health Nurse Practitioner
  • North Little Rock, AR
National Provider Identifier
1609235878
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A004666 Issued in AR
Practice address
308 Smokey LN
North Little Rock, AR 72117-2508
Phone
(501) 771-2799
Fax
(501) 758-6215
NPI assigned
Feb 17, 2016
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A004666 AR Primary
Gerontology Nurse Practitioner 363LG0600X A004666 AR

Addresses

Primary practice location

308 Smokey LN
North Little Rock, AR 72117-2508

Mailing address

308 Smokey LN
North Little Rock, AR 72117-2508
Phone (501) 771-2799

Other identifiers 1

IdentifierTypeStateIssuer
212623758MedicaidAR

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
I20160415000424 AR Practitioner - Nurse Practitioner 5890093405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.56 of 100Reported as group
Quality
96.67
Improvement activities
40
Cost
82.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A004666ARMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Pain Centers LTD CurrentSince May 1, 2021 Accepting new patients
Arkansas Pain Centers, LTD CurrentSince May 1, 2021 Accepting new patients
Venvisor Health of Ar PA CurrentSince Jun 2, 2024 Accepting new patients
Physicians Medical Group PLC PastSince Feb 27, 2016 Accepting new patients

Locations

1202 NE McClain Rd
Bentonville, AR 72712
Phone (855) 632-6940

308 Smokey Ln
North Little Rock, AR 72117
Phone (501) 255-2512

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1609235878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 SMOKEY LN",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172508",
            "telephone_number": "501-771-2799",
            "fax_number": "501-758-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 SMOKEY LN",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172508",
            "telephone_number": "501-771-2799",
            "fax_number": "501-758-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "SHERRY",
        "middle_name": "G",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-17",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "A004666",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "A004666",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212623758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.