NPIMap

Individual provider Active NPI

Carolyn R Smith, APN

  • Family Nurse Practitioner
  • Bee Branch, AR
National Provider Identifier
1750585063
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AO1838 Issued in AR
Practice address
326 South Side Road
Bee Branch, AR 72013-9137
Phone
(501) 654-2006
Fax
(501) 654-2016
NPI assigned
Jun 12, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 AO1838 AR Primary

Addresses

Primary practice location

326 South Side Road
Bee Branch, AR 72013-9137

Mailing address

PO Box 1060
Marshall, AR 72650-1060
Phone (870) 448-5101

Other identifiers 2

IdentifierTypeStateIssuer
166812758MedicaidAR
A01838OtherARSTATE LICENSE

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
I20071213000188 AR Practitioner - Nurse Practitioner 2466481874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

326 Southside Rd
Bee Branch, AR 72013-9137
Phone (501) 654-2006

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AO1838ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Mountain Rural Health Center Inc CurrentSince Jun 29, 2013 Accepting new patients
Boston Mountain Rural Health Center Inc Current Accepting new patients
Boston Mountain Rural Health Center, Inc CurrentSince Jun 29, 2013 Accepting new patients
House Calls, on Call Past Accepting new patients
Community Medical Clinic Past Accepting new patients
Boston Mountain Rural Health Center, Inc PastSince Jun 29, 2013 Accepting new patients

Locations

326 Southside Rd
Bee Branch, AR 72013
Phone (501) 654-2006

934 N Gaskill St
Huntsville, AR 72740
Phone (479) 738-5500

2263 Highway 65 N
Marshall, AR 72650
Phone (870) 741-6065

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAEICA
  • Direct secure messaging: rebecca.smith@bmrhc.eclinicaldirectplus.com

Organizations & group practices 6

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 7

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1750585063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1060",
            "city": "MARSHALL",
            "state": "AR",
            "postal_code": "726501060",
            "telephone_number": "870-448-5101",
            "fax_number": "870-448-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 SOUTH SIDE ROAD",
            "city": "BEE BRANCH",
            "state": "AR",
            "postal_code": "720139137",
            "telephone_number": "501-654-2006",
            "fax_number": "501-654-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAROLYN",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2023-03-07",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "AO1838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166812758",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A01838",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bee Branch, AR

Sources for this page

Verify at the official NPI Registry.