Individual provider Active NPI

Steven Stalker, CRNA

  • Certified Registered Nurse Anesthetist
  • Batesville, AR
National Provider Identifier
1902846587
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R54731 Issued in AR
Practice address
1710 Harrison St
Batesville, AR 72501-7303
Phone
(870) 262-1200
Fax
(870) 262-6063
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R54731 AR Primary

Addresses

Primary practice location

1710 Harrison St
Batesville, AR 72501-7303

Mailing address

PO Box 2197
Batesville, AR 72503-2197
Phone (870) 262-1200

Other identifiers 1

IdentifierTypeStateIssuer
148192701MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050303000991 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 9830143718 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independence Anesthesia LLCGroup PAC ID 3678985355, 3 clinicians

Practice addresses (Care Compare)

1710 Mayfield Dr
Jonesboro, AR 72401-4563
Phone (870) 613-8390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R54731ARMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Anesthesia LLC CurrentSince Jan 4, 2021 Accepting new patients
White River Health System, Inc. Current Accepting new patients
White River Health System, Inc. CurrentSince Jun 20, 2021 Accepting new patients
St. Vincent Infirmary Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1710 Harrison St
Batesville, AR 72501
Phone (870) 262-1240

1710 Harrison St
Ste A
Batesville, AR 72501
Phone (870) 262-3280

1710 Mayfield Dr
Jonesboro, AR 72401
Phone (870) 275-4927

1526 E Main St
Melbourne, AR 72556
Phone (870) 262-3210

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1902846587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2197",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725032197",
            "telephone_number": "870-262-1200",
            "fax_number": "870-262-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017303",
            "telephone_number": "870-262-1200",
            "fax_number": "870-262-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALKER",
        "first_name": "STEVEN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "R54731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148192701",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.