Myra Rutledge Smith

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

213387 Issued in AR

Practice address

1090 Arnold Dr
Little Rock Air Force Base, AR 72099-4933

Phone

(501) 987-3080

NPI assigned

Dec 12, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Icp Arkansas Aco Billing LLC

  • Clinical Nurse Specialist
  • Maumelle, AR
  • NPI 1679157838
  Medicare reassignment NPD
• Integrated Care Professionals, LLC

  • Clinical Nurse Specialist
  • Little Rock, AR
  • NPI 1164762662
  Medicare reassignment NPD

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

{
    "created_epoch": "1607731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1659967834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 ARNOLD DR",
            "city": "LITTLE ROCK AIR FORCE BASE",
            "state": "AR",
            "postal_code": "720994933",
            "telephone_number": "501-987-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 ARNOLD DR",
            "city": "LITTLE ROCK AIR FORCE BASE",
            "state": "AR",
            "postal_code": "720994933",
            "telephone_number": "501-987-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MYRA",
        "middle_name": "RUTLEDGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-12",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "213387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilou Merringer, LCSW
• Robert Anthony Olivi Jr., PA-C
• Payton Quinnell
• Anne Marie Schmidt, D.D.S.
• Lauren Nicole Smith, RN
• Charles Joseph Snyder, D.M.D.
• Donna Jean Taylor, LCSW
• Jessika Twin Taylor, RDH
• Nathaniel Trona, MD
• Kevin Weaver Jr., M.D.

• Family Nurse Practitioner in Little Rock Air Force Base, AR
• Providers in Little Rock Air Force Base, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.