Active NPI
Samnieng M Hernandez, APN
- Family Nurse Practitioner
- Dardanelle, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A003015
- Practice address
- 1652 State Highway 22 W
Dardanelle, AR 72834-2909 - Phone
- (479) 229-8000
- Fax
- (479) 477-3927
- NPI assigned
- Sep 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | R68707 | AR | |
| Family Nurse Practitioner | 363LF0000X | A003015 | AR | Primary |
Addresses
Primary practice location
1652 State Highway 22 W
Dardanelle, AR 72834-2909
Mailing address
PO Box 700
Dardanelle, AR 72834-0700
Phone (479) 229-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 166912758 | Medicaid | AR |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
855 S German LN
Suite 1
Conway, AR 72034-6479
Phone (501) 358-6606
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R68707 | AR | MD | Psychiatric/Mental Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Kirkland Family Medical Center, PA | Current | Accepting new patients | |
| Conway Counseling & Psychological Services, PLLC | Current | Accepting new patients |
Locations
855 S German Ln
Ste 1
Conway, AR 72034
Phone (501) 358-6606
1652 State Highway 22 W
Dardanelle, AR 72834
Phone (479) 229-8000
Interoperability endpoints
- samnieng.hernandez.1@2110.direct.athenahealth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Professional Counselor
- Conway, AR
- NPI 1528454139
-
- Preferred Provider Organization
- Dardanelle, AR
- NPI 1316145022
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Conway Regional Medical Clinic-Vilonia
- Rural Health Clinic/Center
- Vilonia, AR
- NPI 1063798858
Hospital
-
- General Acute Care Hospital
- Conway, AR
- NPI 1497770424
-
dba Conway Regional Medical Clinic-Russellville
- Family Medicine Physician
- Russellville, AR
- NPI 1245729359
Hospital
-
dba Conway Regional Counseling Center
- Psychiatry Physician
- Conway, AR
- NPI 1730402249
Hospital
-
dba Mayflower Medical Clinic
- Rural Health Clinic/Center
- Mayflower, AR
- NPI 1851389605
Hospital
-
dba St . Mary's Regional Medical Center
- General Acute Care Hospital
- Russellville, AR
- NPI 1033160049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1821189879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 700",
"city": "DARDANELLE",
"state": "AR",
"postal_code": "728340700",
"telephone_number": "479-229-8000",
"fax_number": "479-477-3927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1652 STATE HIGHWAY 22 W",
"city": "DARDANELLE",
"state": "AR",
"postal_code": "728342909",
"telephone_number": "479-229-8000",
"fax_number": "479-477-3927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "SAMNIENG",
"middle_name": "M",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-27",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "AR",
"license": "R68707",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A003015",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "166912758",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dardanelle, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.