Individual provider Active NPI

Carolyn Jean Gipson, APRN

  • Family Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1801582457
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
223676 Issued in AR
Practice address
6801 Rogers Ave Ste 5TH
Fort Smith, AR 72903-4067
Phone
(479) 274-2801
NPI assigned
Apr 17, 2023
Last updated
Jul 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 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 223676 AR Primary

Addresses

Primary practice location

6801 Rogers Ave Ste 5TH
Fort Smith, AR 72903-4067

Mailing address

6801 Rogers Ave Ste 5TH
Fort Smith, AR 72903-4067
Phone (479) 274-2801

Other names 1

  • Kris Gipson Other name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230726001456 AR Practitioner - Nurse Practitioner 4587025374 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

701 S Adams St
Lavaca, AR 72941-3833

P O Box
Suite 51266
Lafayette, LA 70505-1266

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Palliative Care at Heart, LLC CurrentSince May 27, 2024 Accepting new patients
Palliative Care at Heart, LLC CurrentSince May 27, 2024 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Jul 10, 2023 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Jul 10, 2023 Accepting new patients

Locations

1401 S Waldron Rd
Ste 201
Fort Smith, AR 72903
Phone (479) 396-4082

6801 Rogers Ave
Fl 5
Fort Smith, AR 72903
Phone (479) 274-4100

6801 Rogers Ave
Ste 5TH
Fort Smith, AR 72903
Phone (479) 274-2801

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

Organizations & group practices 4

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 1

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": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1801582457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 ROGERS AVE STE 5TH",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034067",
            "telephone_number": "479-274-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 ROGERS AVE STE 5TH",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034067",
            "telephone_number": "479-274-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIPSON",
        "first_name": "CAROLYN",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "223676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRIS",
            "last_name": "GIPSON",
            "credential": "APRN, FNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.