MS. DONNA MATLOCK (NPI# 1295780690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295780690 |
| Entity Type | Individual |
| Full Name | MS. DONNA MATLOCK |
| Credential | FNP |
| Practice Address |
2012 S Promenade Blvd Rogers AR 72758 |
| Mailing Address |
2012 S Promenade Blvd Rogers AR 72758-9073 |
| Practice Telephone | 4796161485 |
| Practice Fax Number | 4792390536 |
| Mailing Telephone | 4796161485 |
| Mailing Fax Number | 4792390536 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2019-04-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AO1582 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 148362758 | 05 | |
| AR | RAILROAD MEDICARE | P00378001 | 01 |
| MO | 426270807 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3409 Elm Springs Rd., Springdale, AR 72762 | 4799272100 | 4799272211 |
| Street Address |
2012 S PROMENADE BLVD |
| City | ROGERS |
| State | AR |
| Zip Code | 72758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871570648 | Robert S Venable | Emergency Medicine | 2012 S Promenade Blvd, Rogers, AR 72758-9073 | 2005-12-22 |
| 1235629130 | Janice Lynn Wilson | Nurse Practitioner | 2012 S Promenade Blvd, Rogers, AR 72758 | 2018-05-16 |
| 1770071573 | Juanita Linn Williams | Nurse Practitioner | 2012 S Promenade Blvd, Rogers, AR 72758 | 2018-04-26 |
| 1225546161 | Natalie Mills Krodell | Nurse Practitioner | 2012 S Promenade Blvd, Rogers, AR 72758 | 2018-01-12 |
| 1528570819 | Donna Ann Dansby | Nurse Practitioner | 2012 S Promenade Blvd, Rogers, AR 72758 | 2017-10-26 |
| 1649548926 | Christy Ann Berry | Nurse Practitioner | 2012 S Promenade Blvd, Rogers, AR 72758 | 2011-12-01 |
| 1285956904 | Amanda K. Winfrey | Nurse Practitioner | 2012 S Promenade Blvd, Rogers, AR 72758-9073 | 2010-02-22 |
| 1851586713 | Susan Carol Zwiaska | Physician Assistant | 2012 S Promenade Blvd, Rogers, AR 72758-9073 | 2007-09-12 |
| 1730256926 | Donald William Walker | Nurse Practitioner | 2012 S Promenade Blvd, Rogers, AR 72758 | 2006-11-30 |
| 1952488660 | Carlos Alberto Suarez | Family Medicine | 2012 S Promenade Blvd, Rogers, AR 72758 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417588690 | Premier Hospitalists of Nwa, Pllc | Hospitalist | 4313 S Pleasant Crossing Blvd, Rogers, AR 72758 | 2020-01-28 |
| 1447893235 | Kelsey Elizabeth Sutton | Speech-Language Pathologist | 2100 West Perry Rd, Rogers, AR 72758 | 2019-10-24 |
| 1447700299 | Shannon Kaima | Physician Assistant | 5900 W Stoney Brook Rd Apt 14207, Rogers, AR 72758 | 2016-10-05 |
| 1801345426 | The Exclusive Eye, Pllc | Optometrist | 5100 W Pauline Whitaker Parkway, 107, Rogers, AR 72758 | 2016-09-23 |
| 1780063909 | Nicholas Honea | Nurse Anesthetist, Certified Registered | 4600 Centre Court, Rogers, AR 72758 | 2015-05-20 |
| 1811388945 | Amanda M Hawes | Physician Assistant | 1000 S. 52nd Street, Rogers, AR 72758 | 2015-02-11 |
| 1316354087 | Natalie Horine | Chiropractor | 4305 S Pleasant Crossing Blvd Ste 102, Rogers, AR 72758 | 2014-07-15 |
| 1205248903 | Clyde K. Tempel | Registered Nurse | 2100 W. New Hope Rd. #1804, Rogers, AR 72758 | 2014-05-29 |
| 1548692445 | Becky Tadlock Ross | Pharmacist | 1766 West Laurel, Rogers, AR 72758 | 2013-08-01 |
| 1497190797 | Medical Associates of Northwest Arkansas Pa | Pediatrics | 3730 S Pinnacle Hills Pkwy Ste 3, Rogers, AR 72758 | 2013-05-01 |
| Find all providers in zip 72758 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518582154 | Melisa Swearingen | Nurse Practitioner | 1702 W Kelley Dr, Rogers, AR 72756-2234 | 2020-06-09 |
| 1164044228 | Paige Nichole Bowen | Nurse Practitioner | 1001 S 52nd St, Rogers, AR 72758-8610 | 2020-05-12 |
| 1417587767 | Stephanie Gibson | Nurse Practitioner | 5803 W Murfield Dr, Rogers, AR 72758-4565 | 2020-01-24 |
| 1598315913 | Michaela R Berndt | Nurse Practitioner | 1101 S Promenade Blvd, Rogers, AR 72758-1800 | 2019-09-17 |
| 1790262228 | Melisa Renae Deloach | Nurse Practitioner | 2301 W Pleasant Grove Rd, Rogers, AR 72758-7033 | 2018-07-27 |
| 1740727478 | Kristen Fleming | Nurse Practitioner | 2000 S 42nd St Ste 100, Rogers, AR 72758-2001 | 2017-01-19 |
| 1760925598 | Dana Howard | Nurse Practitioner | 21 S Windsor Dr, Rogers, AR 72758-9504 | 2016-11-28 |
| 1679932321 | Nicole Davis | Nurse Practitioner | 5206 W Village Pkwy Ste 10, Rogers, AR 72758-8137 | 2016-02-22 |
| 1811372204 | Jeannette Marie Carter | Nurse Practitioner | 5507 W Walsh Ln, Suite 101, Rogers, AR 72758-8941 | 2015-07-27 |
| 1225464654 | Julie Angele Raza | Nurse Practitioner | 2708 S Rife Medical Ln Ste 130, Rogers, AR 72758-1455 | 2013-09-17 |
| Find all providers in ROGERS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.