Charlie J Cruce

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

122323 Issued in AR

Practice address

300 S School St
Dermott, AR 71638-2127

Phone

(870) 538-3355

NPI assigned

Oct 11, 2019

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

Other names 1

• Charlie J Gober Former name

Electronic endpoints 1

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mainline Health Systems IncGroup PAC ID 5193785590, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Homecare Home health agency, White Hall, AR, CCN 047093
• Jefferson Regional Medical Center Hospital, Pine Bluff, AR, CCN 040071
• Baptist Health Medical Center-Drew County Hospital, Monticello, AR, CCN 040051

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 and National Provider Directory roles.

• Mainline Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Little Rock, AR
  • NPI 1164264834
  Medicare reassignment Care Compare group NPD
• Mainline Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Monticello, AR
  • NPI 1669401501
  NPD
• Mainline Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Magnolia, AR
  • NPI 1972464337
  NPD
• Mainline Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Portland, AR
  • NPI 1316106388
  NPD (past)

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

• Baptist Health

  • General Acute Care Hospital
  • Monticello, AR
  • NPI 1962283192
  Care Compare affiliation
• Jefferson Hospital Association Inc

  • General Acute Care Hospital
  • Pine Bluff, AR
  • NPI 1710931985
  Care Compare affiliation
• Jefferson Regional Homecare, LLC

  • Home Health Agency
  • White Hall, AR
  • NPI 1891972642
  Care Compare affiliation

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1962044800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 HIGHWAY 425 S",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554612",
            "telephone_number": "870-942-3000",
            "fax_number": "870-942-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S SCHOOL ST",
            "city": "DERMOTT",
            "state": "AR",
            "postal_code": "716382127",
            "telephone_number": "870-538-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUCE",
        "first_name": "CHARLIE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "122323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlie.gober@mhsi.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "300 S School St",
            "city": "Dermott",
            "state": "AR",
            "country_code": "US",
            "postal_code": "716382127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHARLIE",
            "last_name": "GOBER",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebekah Ayecock, PMHNP
• Bio-Medical Applications of Mississippi, Inc.
• CB King JM
• Gary Dalton, DDS
• Delta Drug of Dermott, Inc
• Delta Drug of Dermott, Inc
• Dermott City Nursing Home
• Dermott Day Service Center, Inc.

• Family Nurse Practitioner in Dermott, AR
• Providers in Dermott, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; 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.