Individual provider Active NPI

Elizabeth A Hutson, MD

  • Family Medicine Physician
  • Waldron, AR
National Provider Identifier
1801410527
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-16569 Issued in AR
Practice address
1341 W 6TH St
Waldron, AR 72958-7642
Phone
(479) 637-2136
Fax
(479) 637-5411
NPI assigned
May 29, 2020
Last updated
Sep 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 84377 SC
Family Medicine Physician 207Q00000X E-16569 AR Primary

Addresses

Primary practice location

1341 W 6TH St
Waldron, AR 72958-7642

Mailing address

1341 W 6TH St
Waldron, AR 72958-7642
Phone (479) 637-2136

Other practice location 1

155 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-4865

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehutson289202@selfregional.direct-ci.net

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231206000948 AR Practitioner - Family Practice 1557761459 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital WaldronGroup PAC ID 5597658005, 12 clinicians
Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians

Practice addresses (Care Compare)

100 N Walnut Ave
Mansfield, AR 72944-3522
Phone (479) 928-4404

1341 W 6TH St
Waldron, AR 72958-7642

1414 Hwy 71 N
Alma, AR 72921-4723
Phone (479) 632-0321

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-16569ARMDFamily Medicine Physician
84377SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Waldron CurrentSince Nov 4, 2023 Accepting new patients
Mercy Hospital Booneville CurrentSince May 1, 2024 Accepting new patients
Mercy Hospital Waldron Current Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince May 1, 2024 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince May 1, 2024 Accepting new patients
Mercy Hospital Booneville CurrentSince May 1, 2024 Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

128 Daniel Dr
Booneville, AR 72927
Phone (479) 675-2455

880 W Main St
Booneville, AR 72927
Phone (479) 675-2800

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

1341 W 6th St
Waldron, AR 72958
Phone (479) 637-2136

Organizations & group practices 8

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 6

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": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1801410527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 W 6TH ST",
            "city": "WALDRON",
            "state": "AR",
            "postal_code": "729587642",
            "telephone_number": "479-637-2136",
            "fax_number": "479-637-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 W 6TH ST",
            "city": "WALDRON",
            "state": "AR",
            "postal_code": "729587642",
            "telephone_number": "479-637-2136",
            "fax_number": "479-637-5411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Academy Ave",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296463869",
            "country_code": "US",
            "telephone_number": "864-725-4865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTSON",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "84377",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-16569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehutson289202@selfregional.direct-ci.net",
            "affiliation": "N",
            "address_1": "155 Academy Ave",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296463869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waldron, AR

Sources for this page

Verify at the official NPI Registry.