Individual provider Active NPI

Hania Ziad Al-Shahrouri, MD

  • Nephrology Physician
  • Fort Smith, AR
National Provider Identifier
1861550790
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
E7274 Issued in AR
Practice address
1500 Dodson Ave
Ste 280
Fort Smith, AR 72901-5182
Phone
(479) 709-7480
Fax
(479) 709-7479
NPI assigned
Dec 4, 2006
Last updated
Nov 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X M5612 TX
Nephrology Physician 207RN0300X E7274 AR Primary

Addresses

Primary practice location

1500 Dodson Ave
Ste 280
Fort Smith, AR 72901-5182

Mailing address

PO Box 11449
Belfast, ME 04915-4005
Phone (479) 709-1924

Other identifiers 3

IdentifierTypeStateIssuer
8AC881OtherTXBCBS
185615502MedicaidTX
185615503OtherTXCSHCN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120710000266 AR Practitioner - NephrologyPractitioner - Internal Medicine 7416058409 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Bernards Physician Clinics IncGroup PAC ID 7012311269, 211 clinicians

Practice addresses (Care Compare)

300 Carson St
Jonesboro, AR 72401-3104
Phone (870) 932-1198

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Hospital Inc. CurrentSince Oct 30, 2021 Accepting new patients
St Bernards Physician Clinics, Inc. CurrentSince Jan 1, 2023 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients
St Bernards Physician Clinics Inc CurrentSince Jan 1, 2023 Accepting new patients

Locations

1005 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-1242

1007 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 336-0472

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

201 E Oak Ave
Jonesboro, AR 72401

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

Interoperability endpoints

  • Direct secure messaging: halshahrouri@sbpc.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1861550790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11449",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154005",
            "telephone_number": "479-709-1924",
            "fax_number": "479-709-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DODSON AVE",
            "address_2": "STE 280",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015182",
            "telephone_number": "479-709-7480",
            "fax_number": "479-709-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-SHAHROURI",
        "first_name": "HANIA",
        "middle_name": "ZIAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "M5612",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AR",
            "license": "E7274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8AC881",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185615502",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "185615503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.