Individual provider Active NPI

Mary K Kerby, APN

  • Nurse Practitioner
  • Bella Vista, AR
National Provider Identifier
1811286750
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A003514 Issued in AR
Practice address
1 Mercy Way
Bella Vista, AR 72714-3000
Phone
(479) 802-5555
Fax
(479) 876-2829
NPI assigned
Mar 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A003514 AR Primary

Addresses

Primary practice location

1 Mercy Way
Bella Vista, AR 72714-3000

Mailing address

1 Mercy Way
Bella Vista, AR 72714-3000
Phone (479) 802-5555

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
I20111031000093 AR Practitioner - Nurse Practitioner 7214100668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, 314 clinicians

Practice addresses (Care Compare)

1 Mercy Way
Bella Vista, AR 72714-3000
Phone (479) 802-5555

3101 SE 14TH St
Bentonville, AR 72712-4900
Phone (479) 631-2100

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Rogers, AR, CCN 047149
  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities CurrentSince Oct 18, 2011 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Oct 18, 2011 Accepting new patients

Locations

1 Mercy Way
Bella Vista, AR 72714
Phone (479) 802-5555

1 Mercy Way
Ste 20
Bella Vista, AR 72714
Phone (479) 802-5555

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

Interoperability endpoints

  • Direct secure messaging: mkerby204538@directc.mercy.net

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1811286750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MERCY WAY",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727143000",
            "telephone_number": "479-802-5555",
            "fax_number": "479-876-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCY WAY",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727143000",
            "telephone_number": "479-802-5555",
            "fax_number": "479-876-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERBY",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A003514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bella Vista, AR

Sources for this page

Verify at the official NPI Registry.