Individual provider Active NPI

Shelly Johnson, APRN

  • Family Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1992244800
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A005000 Issued in AR
Practice address
7001 Rogers Ave
Suite 401
Fort Smith, AR 72903-4073
Phone
(479) 314-4650
NPI assigned
Feb 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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 A005000 AR Primary

Addresses

Primary practice location

7001 Rogers Ave
Suite 401
Fort Smith, AR 72903-4073

Mailing address

6107 Ironwood LN
Fort Smith, AR 72916-8870
Phone (479) 769-4835

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
I20170327002098 AR Practitioner - Nurse Practitioner 8123303500 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Iowa, RJ & L Carver College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, shared by 4 NPIs, 361 clinicians

Practice addresses (Care Compare)

3505 S 79TH St
Fort Smith, AR 72903-6250
Phone (479) 709-8686

7001 Rogers Ave
Suite 401a
Fort Smith, AR 72903-4034
Phone (479) 314-4650

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A005000ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Dec 27, 2021 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Apr 1, 2017 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Apr 1, 2017 Accepting new patients

Locations

7001 Rogers Ave
Ste 401A
Fort Smith, AR 72903
Phone (479) 314-4650

2713 S 74th St
Ste 401
Fort Smith, AR 72903
Phone (479) 452-7324

3505 S 79th St
Fort Smith, AR 72903
Phone (479) 709-6729

7001 Rogers Ave
Ste 401
Fort Smith, AR 72903
Phone (479) 314-4650

2901 S 74th St
Fort Smith, AR 72903
Phone (479) 314-1101

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

Organizations & group practices 3

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 3

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": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1992244800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 IRONWOOD LN",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729168870",
            "telephone_number": "479-769-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 ROGERS AVE",
            "address_2": "SUITE 401",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034073",
            "telephone_number": "479-314-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHELLY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.