Individual provider Active NPI

Heron B Martin, APRN

  • Family Nurse Practitioner
  • Springdale, AR
National Provider Identifier
1932591617
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004337 Issued in AR
Practice address
5203 Willow Creek Dr Ste B
Springdale, AR 72762-0876
Phone
(479) 301-8790
Fax
(855) 632-2740
NPI assigned
Mar 4, 2015
Last updated
Sep 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A004337 AR Primary

Addresses

Primary practice location

5203 Willow Creek Dr Ste B
Springdale, AR 72762-0876

Mailing address

5203 Willow Creek Dr Ste B
Springdale, AR 72762-0876
Phone (479) 301-8790

Other identifiers 1

IdentifierTypeStateIssuer
1215794599OtherNPI

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
I20150526002459 AR Practitioner - Nurse Practitioner 7517287972 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5203 Willow Creek Dr
Suite B
Springdale, AR 72762-0876
Phone (479) 283-9958

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A004337ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Siloam Springs Clinic Company LLC Family CurrentSince Dec 21, 2017 Accepting new patients
Northwest Physicians LLC CurrentSince May 1, 2016 Accepting new patients
Northwest Physicians LLC CurrentSince May 1, 2016 Accepting new patients
Clear Creek Wellness Family CurrentSince Jun 3, 2024 Accepting new patients
Totem Health PLLC CurrentSince Feb 1, 2021 Accepting new patients
Northwest Benton County Physician Services LLC CurrentSince May 1, 2016 Accepting new patients

Locations

101 Sun Meadow Dr
Centerton, AR 72719
Phone (479) 273-1426

350 N Razorback Rd
Fayetteville, AR 72701
Phone (479) 575-3334

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

2000 S 42nd St
Ste 100
Rogers, AR 72758
Phone (479) 273-9173

3721 Highway 412 E
#B
Siloam Springs, AR 72761
Phone (479) 215-3070

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

2158 Butterfield Coach Rd
Springdale, AR 72764
Phone (479) 463-7000

3057 Springdale Ave
Springdale, AR 72762
Phone (479) 751-2522

5203 Willow Creek Dr
Ste B
Springdale, AR 72762
Phone (479) 283-9958

5320 W Sunset Ave
Ste 157
Springdale, AR 72762
Phone (479) 966-7331

601 W Maple Ave
Ste 403
Springdale, AR 72764
Phone (479) 750-2742

Organizations & group practices 6

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": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1932591617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 WILLOW CREEK DR STE B",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620876",
            "telephone_number": "479-301-8790",
            "fax_number": "855-632-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5203 WILLOW CREEK DR STE B",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620876",
            "telephone_number": "479-301-8790",
            "fax_number": "855-632-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "HERON",
        "middle_name": "B",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215794599",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.