Individual provider Active NPI

Bailey Madison Burcham, AGNP-C

  • Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1992640742
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AG06260004 Issued in AR
Practice address
3501 We Knight Dr
Fort Smith, AR 72903-6254
Phone
(479) 709-6702
Fax
(479) 709-6710
NPI assigned
Apr 20, 2026
Last updated
Aug 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AG06260004 AR Primary

Addresses

Primary practice location

3501 We Knight Dr
Fort Smith, AR 72903-6254

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (479) 709-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Chicago, IL 60677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AG06260004ARMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1992640742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "479-709-6700",
            "fax_number": "479-709-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 WE KNIGHT DR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729036254",
            "telephone_number": "479-709-6702",
            "fax_number": "479-709-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHAM",
        "first_name": "BAILEY",
        "middle_name": "MADISON",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "AG06260004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.