Soutnakhon Phandanouvong, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

214525 Issued in AR

Practice address

4300 Grand Ave
Fort Smith, AR 72904-7028

Phone

(479) 208-4601

NPI assigned

Jan 11, 2021

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, OK2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Team of Arkansas Physicians LLCGroup PAC ID 1850539198, 155 clinicians

Arkansas Lung Center PLLCGroup PAC ID 2769838812, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062
• Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055
• Sequoyah County-City of Sallisaw Hospital Authorit Hospital, Sallisaw, OK, CCN 370112
• Mercy Rehabilitation Hospital Inpatient rehabilitation facility, Fort Smith, AR, CCN 043037

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BIBDDD

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.

• Arkansas Lung Center PLLC

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1447036108

  Family, OK

  Medicare reassignment Care Compare group NPD
• Urgent Team of Arkansas Physicians, LLC

  • Rural Health Clinic/Center
  • Searcy, AR
  • NPI 1992041370
  Medicare reassignment Care Compare group
• Mercy Northwest Arkansas Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springdale, AR
  • NPI 1366922320
  Medicare reassignment NPD
• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  NPD (past)

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

• Baptist Health Regional Hospitals

  dba Baptist Health - Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1710463146
  Care Compare affiliation
• Mercy Hospital Fort Smith

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

  dba Mercy Rehabilitation Hospital

  • Rehabilitation Hospital
  • Fort Smith, AR
  • NPI 1699365254

  Inpatient rehabilitation facility

  Care Compare affiliation
• Sequoyah County City of Sallisaw Hospital Authority

  dba Sequoyah Memorial Hospital

  • Rural Acute Care Hospital
  • Sallisaw, OK
  • NPI 1972539567
  Care Compare affiliation

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1780273250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5728 KIBLER RD",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729567576",
            "telephone_number": "479-459-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 GRAND AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729047028",
            "telephone_number": "479-208-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHANDANOUVONG",
        "first_name": "SOUTNAKHON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "214525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelynn Pettenger
• Marie Pham-Russell, DNP
• Thuylinh Pham, M.D.
• Alexander Phan
• Carol Ngoc Phan
• Michael Victor Pharis, DPT
• Pharmaceutical Investment Corp. (Vaughn Prescription Drug Store)
• Pharmacy Specialties Group (Inc) (PSG Pharmacy)
• Sonexay Phasouvor, MHPP
• Taylor Phavong

• Family Nurse Practitioner in Fort Smith, AR
• Providers in Fort Smith, 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 5, 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.