Amy Deatherage

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2014012328 Issued in AR

Practice address

1 Medical Dr Ste 100
Paragould, AR 72450-4005

Phone

(870) 932-0399

NPI assigned

Sep 6, 2014

Last updated

Mar 31, 2025By the provider in NPPES

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

TBD Health Enterprises of Arkansas PLLCGroup PAC ID 1951845163, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.deatherage.1@22374.direct.athenahealth.com

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.

• TBD Health Enterprises of Arkansas PLLC

  dba Arkansas Pain Specialists

  • Interventional Pain Medicine Physician
  • Fort Smith, AR
  • NPI 1760242440
  Medicare reassignment Care Compare group NPD
• Pain & Interventional Radiology Specialists, P.a.

  dba Interventional Pain Management Center

  • Interventional Pain Medicine Physician
  • Jonesboro, AR
  • NPI 1144674409
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  AR

  Medicare reassignment NPD
• TBD Health Enterprises of Arkansas PLLC

  dba Arkansas Pain Specialists

  • Interventional Pain Medicine Physician
  • Springdale, AR
  • NPI 1376497438
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation

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

{
    "created_epoch": "1409961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1720489032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL DR STE 100",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504005",
            "telephone_number": "870-932-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL DR STE 100",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504005",
            "telephone_number": "870-932-0399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2707 Market Trace",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729088694",
            "country_code": "US",
            "telephone_number": "479-434-3600",
            "fax_number": "833-992-0797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEATHERAGE",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-06",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "2014012328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Erin Davis
• Jessica Avery Day, MCD, CFY-SLP
• Dayspring Behavioral Health
• Dayspring Services of Arkansas LLC
• Whitney Dean
• Samantha Dees
• Louisaac Anthony Delices
• Daniel Delpino
• Dement Internal Medicine Clinic, P.a.
• William T Dement, MD

• Family Nurse Practitioner in Paragould, AR
• Providers in Paragould, 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 Mar 31, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.