Individual provider Active NPI

Donna Lynn Gullette, APN, ACNP-BC

  • Acute Care Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1811283906
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
A03545 Issued in AR
Practice address
1811 Rahling Rd
Suite 120
Little Rock, AR 72223-4677
Phone
(501) 614-2340
Fax
(501) 614-2349
NPI assigned
Jun 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X A03545 AR Primary

Addresses

Primary practice location

1811 Rahling Rd
Suite 120
Little Rock, AR 72223-4677

Mailing address

1811 Rahling Rd
Suite 120
Little Rock, AR 72223-4677
Phone (501) 614-2340

Other identifiers 1

IdentifierTypeStateIssuer
198195758MedicaidAR

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
I20130710000208 AR Practitioner - Nurse Practitioner 9234379512 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A03545ARMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2013 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2013 Accepting new patients

Locations

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

1811 Rahling Rd
Ste 120
Little Rock, AR 72223
Phone (501) 214-2360

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1811283906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 RAHLING RD",
            "address_2": "SUITE 120",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234677",
            "telephone_number": "501-614-2340",
            "fax_number": "501-614-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 RAHLING RD",
            "address_2": "SUITE 120",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234677",
            "telephone_number": "501-614-2340",
            "fax_number": "501-614-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLETTE",
        "first_name": "DONNA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "APN, ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A03545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198195758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.