NPIMap

Individual provider Active NPI

Trace Nathaniel Garner, M.D.

  • Cardiovascular Disease Physician
  • Monticello, AR
National Provider Identifier
1982921391
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
E-8037 Issued in AR
Practice address
766 H L Ross Dr
Monticello, AR 71655-5706
Phone
(870) 412-4302
Fax
(870) 412-4178
NPI assigned
Apr 24, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X E-8037 AR Primary

Addresses

Primary practice location

766 H L Ross Dr
Monticello, AR 71655-5706

Mailing address

10100 Kanis Rd
Little Rock, AR 72205-6202
Phone (501) 255-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130905000126 AR Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6800039124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Arkansas College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Infirmary Medical CenterGroup PAC ID 5698674166, 44 clinicians

Practice addresses (Care Compare)

10100 Kanis Rd
Little Rock, AR 72205-6202
Phone (501) 255-6000

Hospital & facility affiliations

  • Baptist Health Medical Center-Drew County Hospital, Monticello, AR, CCN 040051
  • CHI-St Vincent Infirmary Hospital, Little Rock, AR, CCN 040007
  • Bradley County Medical Center Hospital, Warren, AR, CCN 041327
  • Jefferson Regional Medical Center Hospital, Pine Bluff, AR, CCN 040071
  • Ashley County Medical Center Hospital, Crossett, AR, CCN 041323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Infirmary Medical Center CurrentSince Aug 1, 2017 Accepting new patients
St. Vincent Infirmary Medical Center CurrentSince Aug 1, 2017 Accepting new patients
St. Vincent Infirmary Medical Center Current Accepting new patients
St. Vincent Infirmary Medical Center Current Accepting new patients
Heart Clinic Arkansas Cardiovascular Disease Current Accepting new patients
St Vincent Infirmary Medical Center Past Accepting new patients

Locations

10100 Kanis Rd
Little Rock, AR 72205
Phone (501) 255-6000

1708 N Buerkle St
Stuttgart, AR 72160
Phone (870) 659-8050

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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": "1272067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1982921391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056202",
            "telephone_number": "501-255-6000",
            "fax_number": "501-255-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "766 H L ROSS DR",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716555706",
            "telephone_number": "870-412-4302",
            "fax_number": "870-412-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNER",
        "first_name": "TRACE",
        "middle_name": "NATHANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-24",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "E-8037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, AR

Sources for this page

Verify at the official NPI Registry.