NPIMap

Individual provider Active NPI

Nathan A Gladden, NP

  • Nurse Practitioner
  • Lake Village, AR
National Provider Identifier
1619545829
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
216314 Issued in AR
Practice address
103 Wood Duck LN
Lake Village, AR 71653-7590
Phone
(870) 538-7225
NPI assigned
Jun 14, 2021
Last updated
Jul 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 216314 AR Primary
Family Nurse Practitioner 363LF0000X 216314 AR

Addresses

Primary practice location

103 Wood Duck LN
Lake Village, AR 71653-7590

Mailing address

103 Wood Duck LN
Lake Village, AR 71653-7590
Phone (870) 538-7225

Other names 1

  • Nathan Alan Gladden Other name

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
I20210814000333 AR Practitioner - Nurse Practitioner 9638573504 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Emergency Staffing Solutions IncGroup PAC ID 3274681341, 14 clinicians
Lake Village Clinic PAGroup PAC ID 3274575162, 8 clinicians
Concord Company of Arkansas PLLCGroup PAC ID 4082968623, 11 clinicians

Practice addresses (Care Compare)

2729 S Hwy 65 and 82
Lake Village, AR 71653-6136
Phone (870) 265-5351

2918 Louis Sessions St
Lake Village, AR 71653-6049
Phone (870) 265-5343

700 W Grove St
El Dorado, AR 71730-4416
Phone (870) 863-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216314ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HCC of El Dorado LLC CurrentSince Nov 1, 2021 Accepting new patients
Concord Medical Group PLLC CurrentSince Jul 19, 2024 Accepting new patients
South Arkansas Emergency Physicians, LLP Nurse Practitioner CurrentSince Jul 9, 2021 Accepting new patients
South Arkansas Emergency Physicians, LLP Nurse Practitioner CurrentSince Jul 9, 2021 Accepting new patients
Arkansas Emergency Staffing Solutions, Inc CurrentSince Apr 1, 2023 Accepting new patients
Lake Village Clinic PA CurrentSince Aug 1, 2021 Accepting new patients
Concord Company of Arkansas PLLC CurrentSince Jul 19, 2024 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Jul 19, 2024 Accepting new patients
Ess of El Dorado, LLC CurrentSince Nov 1, 2021 Accepting new patients
South Arkansas Emergency Physicians LLP Nurse Practitioner Current Accepting new patients

Locations

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

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

1801 Martin Luther King Jr Dr
Helena, AR 72342
Phone (870) 338-5800

2729 S Highway 65 82
Lake Village, AR 71653
Phone (870) 265-5351

2918 Louis Sessions St
Lake Village, AR 71653
Phone (870) 265-5343

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCCAAA

Organizations & group practices 11

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 5

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": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1619545829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WOOD DUCK LN",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716537590",
            "telephone_number": "870-538-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WOOD DUCK LN",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716537590",
            "telephone_number": "870-538-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADDEN",
        "first_name": "NATHAN",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "216314",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "216314",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATHAN",
            "last_name": "GLADDEN",
            "middle_name": "ALAN",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lake Village, AR

Sources for this page

Verify at the official NPI Registry.