Organization Active NPI

Haertling Family Practice PLLC

  • Family Nurse Practitioner
  • Batesville, AR
National Provider Identifier
1821789785
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
HAERTLING FAMILY PRACTICE PLLC
Practice address
940 23Rd St
Batesville, AR 72501-6037
Phone
(870) 569-4341
Fax
(870) 569-4004
NPI assigned
May 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Authorized official

Name
Mr. Eric Benjamin Haertling, APRNNPI 1245666536
Title
Owner
Phone
(870) 598-4075

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

940 23Rd St
Batesville, AR 72501-6037

Mailing address

940 23Rd St
Batesville, AR 72501-6037
Phone (870) 569-4341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230724000011 AR Part B Supplier - Clinic/Group Practice 9931569928 Receives reassigned benefits from 1 practitioner
Practice locations: Batesville, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2296588Haertling Family Practice940 23Rd St, Batesville, AR 72501Certificate of waiverJan 1, 2028

National Provider Directory

National Provider Directory

Locations

940 23rd St
Batesville, AR 72501
Phone (870) 569-4341

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1821789785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 23RD ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725016037",
            "telephone_number": "870-569-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 23RD ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725016037",
            "telephone_number": "870-569-4341",
            "fax_number": "870-569-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAERTLING FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "HAERTLING",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-598-4075",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.