Individual provider Active NPI

Nicole Danise Bates, APRN, FNP-BC

  • Family Nurse Practitioner
  • Sheridan, AR
National Provider Identifier
1629518683
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A005024 Issued in AR
Practice address
810 S Rock St
Sheridan, AR 72150-7066
Phone
(870) 917-2289
NPI assigned
Feb 24, 2017
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A005024 AR Primary

Addresses

Primary practice location

810 S Rock St
Sheridan, AR 72150-7066

Mailing address

4196 Highway 62 412 Ste a
Hardy, AR 72542-8002

Other practice location 1

1007 Fairway Dr
Pine Bluff, AR 71603-8105
Phone (870) 718-6329

Other practice location 2

8907 Kanis Rd Ste 330
Little Rock, AR 72205-6451
Phone (501) 224-8810

Other identifiers 1

IdentifierTypeStateIssuer
581274YN39OtherARPTAN

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005024ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition for You LLC CurrentSince Aug 13, 2018 Accepting new patients

Locations

9601 Baptist Health Dr
Ste 400
Little Rock, AR 72205
Phone (501) 224-2141

Organizations & group practices 1

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": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1629518683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4196 HIGHWAY 62 412 STE A",
            "city": "HARDY",
            "state": "AR",
            "postal_code": "725428002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S ROCK ST",
            "city": "SHERIDAN",
            "state": "AR",
            "postal_code": "721507066",
            "telephone_number": "870-917-2289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 Fairway Dr",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716038105",
            "country_code": "US",
            "telephone_number": "870-718-6329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8907 Kanis Rd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722056451",
            "country_code": "US",
            "telephone_number": "501-224-8810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATES",
        "first_name": "NICOLE",
        "middle_name": "DANISE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-24",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "581274YN39",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, AR

Sources for this page

Verify at the official NPI Registry.