Khali Houart, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

230587 Issued in AR

Practice address

3644 W State Highway 18 Ste B
Manila, AR 72442-8049

Phone

(870) 561-3300

Fax

(870) 561-3307

NPI assigned

Sep 26, 2024

Last updated

Sep 26, 2024By the provider in NPPES

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

T W Wagner IncGroup PAC ID 1153359096, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• T W Wagner Inc

  dba Wagner Medical Clinic

  • Family Medicine Physician
  • Manila, AR
  • NPI 1720183031
  Medicare reassignment Care Compare group NPD
• T W Wagner Inc

  • Rural Health Clinic/Center
  • Lepanto, AR
  • NPI 1114734969
  NPD
• T W Wagner Inc

  dba Wagner Medical Clinic

  • Rural Health Clinic/Center
  • Lepanto, AR
  • NPI 1316041957
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Bernards Hospital Inc

  dba St Bernards Medical Center

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1922043686
  Care Compare affiliation

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1902624299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3644 W STATE HIGHWAY 18 STE B",
            "city": "MANILA",
            "state": "AR",
            "postal_code": "724428049",
            "telephone_number": "870-561-3300",
            "fax_number": "870-561-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3644 W STATE HIGHWAY 18 STE B",
            "city": "MANILA",
            "state": "AR",
            "postal_code": "724428049",
            "telephone_number": "870-561-3300",
            "fax_number": "870-561-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUART",
        "first_name": "KHALI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AR",
            "license": "230587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angie D Hicks-Master, ANP
• Allison Hitchcock, QBHP
• Allison Nicole Hitt, ARPN
• Yvonne Holmes, LMSW
• Home Oxygen Care, Inc.
• Mystique Leigh Imler, LPC
• Anna Geneva Jackson, QBHP
• Jeremy A Jackson, PHARMD
• Matthew Jackson, PD
• Whitney E Jackson, MCD, CF-SLP

• Primary Care Nurse Practitioner in Manila, AR
• Providers in Manila, AR by specialty
• Primary Care Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.
• 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.