Individual provider Active NPI

Tiffany Hearnsberger

  • Nurse Practitioner
  • El Dorado, AR
National Provider Identifier
1871039610
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A004997 Issued in AR
Practice address
701 N West Ave
El Dorado, AR 71730-4654
Phone
(870) 466-4308
NPI assigned
Jan 18, 2017
Last updated
Jan 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A004997 AR Primary

Addresses

Primary practice location

701 N West Ave
El Dorado, AR 71730-4654

Mailing address

701 N West Ave
El Dorado, AR 71730-4654
Phone (870) 466-4308

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170926000620 AR Practitioner - Nurse Practitioner 4981978251 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Associates LLCGroup PAC ID 3476818378, 3 clinicians

Practice addresses (Care Compare)

50 Hwy 79 N
Magnolia, AR 71753-3265
Phone (870) 234-7435

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A004997ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Arkansas Emergency Physicians, LLP Nurse Practitioner CurrentSince Aug 6, 2017 Accepting new patients
South Arkansas Emergency Physicians, LLP Nurse Practitioner CurrentSince Aug 6, 2017 Accepting new patients
Urgent Care Associates LLC CurrentSince Jul 17, 2018 Accepting new patients
South Arkansas Emergency Physicians LLP Nurse Practitioner Current Accepting new patients

Locations

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

50 Highway 79 Byp N
Ste C
Magnolia, AR 71753
Phone (870) 234-7435

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

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": "1484697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1871039610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N WEST AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304654",
            "telephone_number": "870-466-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N WEST AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304654",
            "telephone_number": "870-466-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARNSBERGER",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-18",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A004997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

Verify at the official NPI Registry.