Individual provider Active NPI

Robert Calynn Cluck, APRN

  • Family Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1992395966
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
214593 Issued in AR
Practice address
6801 Rogers Ave Ste 5TH
Fort Smith, AR 72903-4067
Phone
(479) 274-4100
NPI assigned
Jan 22, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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 214593 AR Primary

Addresses

Primary practice location

6801 Rogers Ave Ste 5TH
Fort Smith, AR 72903-4067

Mailing address

6801 Rogers Ave Ste 5TH
Fort Smith, AR 72903-4067
Phone (479) 274-4100

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
I20211022000110 AR Practitioner - Nurse Practitioner 5890183909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Fort Smith Communities 361 clinicians

Practice addresses (Care Compare)

6801 Rogers Ave
FL 5
Fort Smith, AR 72903-4067
Phone (479) 274-4100

Hospital & facility affiliations

  • Traditions Health of Stigler Home health agency, Stigler, OK, CCN 377162
  • Access Home Health Home health agency, Fort Smith, AR, CCN 047009
  • Elite Home Health Home health agency, Fort Smith, AR, CCN 047339
  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062
  • Mercy Hospital Paris Hospital, Paris, AR, CCN 041300
  • Sequoyah County-City of Sallisaw Hospital Authorit Hospital, Sallisaw, OK, CCN 370112
  • Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214593ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Oct 18, 2021 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Oct 18, 2021 Accepting new patients

Locations

6801 Rogers Ave
Ste 502
Fort Smith, AR 72903

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

6801 Rogers Ave
Ste 5TH
Fort Smith, AR 72903
Phone (479) 274-2801

6801 Rogers Ave
Fl 5
Fort Smith, AR 72903
Phone (479) 274-4100

Organizations & group practices 4

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 7

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": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1992395966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 ROGERS AVE STE 5TH",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034067",
            "telephone_number": "479-274-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 ROGERS AVE STE 5TH",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034067",
            "telephone_number": "479-274-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUCK",
        "first_name": "ROBERT",
        "middle_name": "CALYNN",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "214593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.