Susan Rebekah Stuck

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-905 Issued in AR

Practice address

1652 State Highway 22 W
Dardanelle, AR 72834-2909

Phone

(479) 229-8000

Fax

(479) 477-3925

NPI assigned

Feb 14, 2019

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• East Arkansas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Blytheville, AR
  • NPI 1932442985
  Medicare reassignment
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  AR

  Medicare reassignment
• East Arkansas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Osceola, AR
  • NPI 1043553860

  Physician Assistant

  NPD
• East Arkansas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Clarksville, AR
  • NPI 1609259753

  Physician Assistant

  NPD

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1861958951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 STATE HIGHWAY 22 W",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728342909",
            "telephone_number": "479-229-8000",
            "fax_number": "479-477-3925"
        },
        {
            "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": "479-477-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCK",
        "first_name": "SUSAN",
        "middle_name": "REBEKAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanna Shockley, APRN
• Charles Burrell Smith Jr., D.C.
• Annette Kay Snider, LCSW
• State of Arkansas (Yell County Health Unit Dardanelle)
• Kristy Leigh Stokes, L.P.C.
• Taylor Made Counseling & Wellness PLLC
• Rebekah Taylor, LCSW
• The Kirkland Family Medical Center, PA
• Kimberly Via
• Walmart Inc.

• Physician Assistant in Dardanelle, AR
• Providers in Dardanelle, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.