Soutnakhon Phandanouvong, APRN - Medicare Nurse Practitioner in Mulberry, AR

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Soutnakhon Phandanouvong, APRN is a medicare enrolled "Nurse Practitioner - Family" in Mulberry, Arkansas. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice River Valley Primary Care Services, Urgent Team Of Arkansas Physicians Llc and her current practice location is 421 N Main St, Mulberry, Arkansas. You can reach out to her office (for appointments etc.) via phone at (479) 997-1484.

Soutnakhon Phandanouvong is licensed to practice in Arkansas (license number 214525) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1780273250.

Contact Information

Soutnakhon Phandanouvong, APRN
421 N Main St,
Mulberry, AR 72947-8574
(479) 997-1484
Not Available

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Provider's Profile

Full NameSoutnakhon Phandanouvong
GenderFemale
SpecialityNurse Practitioner
Experience4 Years
Location421 N Main St, Mulberry, Arkansas
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Soutnakhon Phandanouvong graduated from nursing school in 2020
  NPI Data:
  • NPI Number: 1780273250
  • Provider Enumeration Date: 01/11/2021
  • Last Update Date: 01/11/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 2163837949
  • Enrollment ID: I20210209002792

Medical Identifiers

Medical identifiers for Soutnakhon Phandanouvong such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1780273250NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 214525 (Arkansas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Mercy Hospital Fort SmithFort smith, ARHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
River Valley Primary Care Services004227427636
Urgent Team Of Arkansas Physicians Llc1850539198125

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Soutnakhon Phandanouvong allows following entities to bill medicare on her behalf.
Entity NameRiver Valley Primary Care Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1952349003
PECOS PAC ID: 0042274276
Enrollment ID: O20050503001398
Entity NameUrgent Team Of Arkansas Physicians Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1992041370
PECOS PAC ID: 1850539198
Enrollment ID: O20130529000209

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Soutnakhon Phandanouvong is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Soutnakhon Phandanouvong, APRN
1101 Sunnyside Rd,
Alma, AR 72921-7301

Ph: (479) 459-0046		Soutnakhon Phandanouvong, APRN
421 N Main St,
Mulberry, AR 72947-8574

Ph: (479) 997-1484

Reviews and Comments


Nurse Practitioner Nurses in Mulberry, AR


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.