Cherrie Phouthavong

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

A004626 Issued in AR

Practice address

7301 Rogers Ave
Fort Smith, AR 72903-4100

Phone

(479) 314-6992

NPI assigned

Jan 25, 2016

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, 361 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Fort Smith Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Smith, AR
  • NPI 1790258002
  NPD

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

• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1952768780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 MILLENNIUM DR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729168825",
            "telephone_number": "479-461-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034100",
            "telephone_number": "479-314-6992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOUTHAVONG",
        "first_name": "CHERRIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A004626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Health Associates of Fort Smith
• Phoenix Mobile Physical Therapy LLC
• Chansamone M Phomakay, MD
• Von Phomakay, DO
• Alisa Phommavong
• Kaylee Lauren Pickartz, BCBA
• Randelle Pickens
• Gena Pierce, MD, RDN, LDN
• Makenzie Pierce
• Willie Centel Piggee Jr.

• Acute Care Nurse Practitioner in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Acute Care Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.