Mary Melinda Ericson, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-220 Issued in AR

Practice address

3721 E US 412 Hwy Ste B
Siloam Springs, AR 72761-3018

Phone

(479) 215-3080

Fax

(479) 549-4059

NPI assigned

Jun 15, 2006

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

Other names 1

• Ms. Mary Melinda Kimberlin Former name

Medicare fee-for-service enrollment

Enrolled in AR, MO2 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

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022
• Siloam Springs Regional Hospital Hospital, Siloam Springs, AR, CCN 040001

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1036.epichosted.com/APIProxyPRD/AC/api/FHIR/R4

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 Childrens Professional Services Organization LLC

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1629889464
  Medicare reassignment NPD
• Mercy Northwest Arkansas Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springdale, AR
  • NPI 1366922320
  Medicare reassignment
• Northwest Benton County Physician Services LLC

  • Family Medicine Physician
  • Bentonville, AR
  • NPI 1871553073
  Medicare reassignment
• Northwest Physicians LLC

  • Obstetrics Physician
  • Springdale, AR
  • NPI 1194768721
  Medicare reassignment
• Siloam Springs Clinic Company LLC

  • Internal Medicine Physician
  • Siloam Springs, AR
  • NPI 1013155431
  Medicare reassignment
• South Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • El Dorado, AR
  • NPI 1942435458
  Medicare reassignment
• Springdale- Bentonville HBP Services, LLC

  • Neonatal-Perinatal Medicine Physician
  • Bentonville, AR
  • NPI 1811762701
  Medicare reassignment
• Ies Arkansas PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1598488090

  AR

  Medicare reassignment
• Missouri HB Medical Services, LLC

  • Emergency Medicine Physician
  • Poplar Bluff, MO
  • NPI 1922868462
  Medicare reassignment
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  AR

  Medicare reassignment
• Northwest Physicians LLC

  • Durable Medical Equipment & Medical Supplies
  • Springdale, AR
  • NPI 1205137536
  NPD
• South Arkansas Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Siloam Springs, AR
  • NPI 1225452055
  NPD

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

• Northwest Arkansas Hospitals, LLC

  • General Acute Care Hospital
  • Springdale, AR
  • NPI 1699726695
  Care Compare affiliation
• Siloam Springs Arkansas Hospital Company LLC

  • General Acute Care Hospital
  • Siloam Springs, AR
  • NPI 1902051816
  Care Compare affiliation

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1811931397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 E US 412 HWY STE B",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727613018",
            "telephone_number": "479-215-3080",
            "fax_number": "479-549-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 E US 412 HWY STE B",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727613018",
            "telephone_number": "479-215-3080",
            "fax_number": "479-549-4059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2012 S Promenade Blvd",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727589073",
            "country_code": "US",
            "telephone_number": "479-616-1485",
            "fax_number": "479-239-0536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICSON",
        "first_name": "MARY",
        "middle_name": "MELINDA",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": "PA-220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KIMBERLIN",
            "middle_name": "MELINDA",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caleb Paxton Edwards, P.T.
• Natalie Zoe Eiland, D.O.
• Sonya E Ellis
• Lori M Embree
• Stacey Lynn Enlow, APN
• Barbara Ervin, APRN
• Kenia Oneyda Espinal
• Elisabeth Michelle Evans, LAC
• Poiema Evans
• Tiffany Kay Evans, ATC/LAT

• Medical Physician Assistant in Siloam Springs, AR
• Providers in Siloam Springs, AR by specialty
• Medical Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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.