Individual provider Active NPI

Laurie A Allen, PA-C

  • Physician Assistant
  • Springdale, AR
National Provider Identifier
1962826503
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-538 Issued in AR
Practice address
2601 Gene George Blvd
Springdale, AR 72762-0845
Phone
(797) 256-8004
Fax
(479) 725-6582
NPI assigned
Feb 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-538 AR Primary

Addresses

Primary practice location

2601 Gene George Blvd
Springdale, AR 72762-0845

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other practice location 1

2710 S Rife Medical Ln
Rogers, AR 72758-1452
Phone (479) 338-8000

Other names 1

  • Ms. Laurie A Nelson Former name

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
I20150123000315 AR Practitioner - Physician Assistant 0143544072 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-538ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Aug 30, 2024 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Nov 1, 2014 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 30, 2024 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Nov 1, 2014 Accepting new patients
Arkansas Childrens Hospital CurrentSince Aug 30, 2024 Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients
Mercy Health Northwest Arkansas Communities Past Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

Organizations & group practices 9

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": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1962826503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 GENE GEORGE BLVD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620845",
            "telephone_number": "797-256-8004",
            "fax_number": "479-725-6582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2710 S Rife Medical Ln",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727581452",
            "country_code": "US",
            "telephone_number": "479-338-8000",
            "fax_number": "479-338-2906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "LAURIE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "NELSON",
            "middle_name": "A",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.