Dusty Marie Colburn, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

A005776 Issued in AR

Practice address

4900 Kelley Hwy
Fort Smith, AR 72904-5000

Phone

(479) 785-5700

Fax

(479) 785-5708

NPI assigned

Jul 16, 2018

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

Other identifiers 1

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, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• River Valley Primary Care Services

  • Federally Qualified Health Center (FQHC)
  • Ratcliff, AR
  • NPI 1952349003
  Medicare reassignment
• River Valley Primary Care Services

  • Community/Retail Pharmacy
  • Mountainburg, AR
  • NPI 1164222113
  NPD
• River Valley Primary Care Services

  • Federally Qualified Health Center (FQHC)
  • Fort Smith, AR
  • NPI 1568647519
  NPD
• Jcwhit P.a.

  • Pediatrics Physician
  • Fort Smith, AR
  • NPI 1609919836
  NPD (past)
• River Valley Primary Care Services

  • Federally Qualified Health Center (FQHC)
  • Fort Smith, AR
  • NPI 1023163193
  NPD (past)

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1730665449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 KELLEY HWY",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729045000",
            "telephone_number": "479-785-5700",
            "fax_number": "479-785-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 KELLEY HWY",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729045000",
            "telephone_number": "479-785-5700",
            "fax_number": "479-785-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBURN",
        "first_name": "DUSTY",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AR",
            "license": "A005776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137012001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joni Cogbill, SPEECH PATHOLOGIST
• Tracy Dawn Cohen, FNP
• Holley Michelle Coker, PA-C
• Lisa Deniece Coker, APRN
• Crystal Colburn, BT
• Cole J. Johnson DDS PA
• Amanda L Cole, AGACNP-BC
• Kelsey Ann Cole, DNP
• Michael S Cole, MD
• Coleman Butler Ft Smith LLC

• Pediatric Nurse Practitioner in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Pediatric Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.