Individual provider Active NPI

Mary Christine Merrell, FNP-BC

  • Family Nurse Practitioner
  • Siloam Springs, AR
National Provider Identifier
1952081556
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023060388 Issued in AR
Practice address
413 S Wright St
Siloam Springs, AR 72761-3515
Phone
(479) 220-2341
NPI assigned
Jul 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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 2023060388 AR Primary

Addresses

Primary practice location

413 S Wright St
Siloam Springs, AR 72761-3515

Mailing address

413 S Wright St
Siloam Springs, AR 72761-3515
Phone (479) 220-2341

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
I20231129000035 AR Practitioner - Nurse Practitioner 9335597517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2069 N Crossover Rd
Suite 2
Fayetteville, AR 72703-4327
Phone (479) 718-6470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023060388ARMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1952081556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 S WRIGHT ST",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727613515",
            "telephone_number": "479-220-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 S WRIGHT ST",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727613515",
            "telephone_number": "479-220-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRELL",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "2023060388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Siloam Springs, AR

Sources for this page

Verify at the official NPI Registry.