Individual provider Active NPI

Kathleen Suzan Street, D.O.

  • Obstetrics & Gynecology Physician
  • Fort Smith, AR
National Provider Identifier
1871880278
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
E-9166 Issued in AR
Practice address
7001 Rogers Ave Ste 502
Fort Smith, AR 72903-4041
Phone
(479) 484-5901
Fax
(479) 484-0778
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X E-9166 AR Primary
Obstetrics & Gynecology Physician 207V00000X T-2492 MS

Addresses

Primary practice location

7001 Rogers Ave Ste 502
Fort Smith, AR 72903-4041

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (479) 484-5901

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5339

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
I20160128001006 AR Practitioner - Obstetrics/Gynecology 8123342193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7001 Rogers Ave
FL 5
Fort Smith, AR 72903-4073
Phone (479) 314-7490

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-2492MSMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince May 1, 2024 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince May 1, 2024 Accepting new patients
Mercy Hospital Fort Smith Past Accepting new patients

Locations

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

7001 Rogers Ave
Ste 502
Fort Smith, AR 72903
Phone (479) 484-5901

7001 Rogers Ave
Fl 5
Fort Smith, AR 72903
Phone (479) 314-7490

Organizations & group practices 3

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.

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1871880278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "479-484-5901",
            "fax_number": "479-484-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 ROGERS AVE STE 502",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034041",
            "telephone_number": "479-484-5901",
            "fax_number": "479-484-0778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STREET",
        "first_name": "KATHLEEN",
        "middle_name": "SUZAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "E-9166",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "T-2492",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.