Lori Fawbush (NPI# 1760646020, PAC ID# 5496648735) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1760646020 |
| PAC ID by PECOS | 5496648735 |
| Professional Enrollment ID | I20040202001188 |
| Full Name | Lori Fawbush |
| Organization Legal Name | ST VINCENT MEDICAL GROUP |
| Address |
15033 Hwy 165 Scott AR 72142-9555 |
| Phone Number | 5015527999 |
| Gender | F |
| Credential | NP |
| Graduation Year | 2003 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 5698758803 |
| Number of Group Practice Members | 123 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 040007 | CHI-ST VINCENT INFIRMARY |
| 040137 | ST VINCENT MEDICAL CENTER/NORTH |
| 040036 | BAPTIST HEALTH MEDICAL CENTER NORTH LITTLE ROCK |
| Address | Phone | Organization |
|---|---|---|
| 10001 Lile Dr, Little Rock, AR 72205-6217 | 5012278000 | ST VINCENT MEDICAL GROUP |
| 10001 Lile Dr, Fl 2, Little Rock, AR 72205-6217 | 5015525550 | ST VINCENT MEDICAL GROUP |
| 2 Saint Vincent Cir, Little Rock, AR 72205-5423 | 5015524666 | ST VINCENT MEDICAL GROUP |
| 5 Saint Vincent Cir, Little Rock, AR 72205-5412 | 5015526400 | ST VINCENT MEDICAL GROUP |
| 15033 Hwy 165, Scott, AR 72142-9555 | 5015527999 | ST VINCENT MEDICAL GROUP |
| Organization Legal Name | ST VINCENT MEDICAL GROUP |
| Physicians | 116 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chen Wang | Family Medicine | St Vincent Medical Group | 4202 S University Ave, Little Rock, AR 72204-7841 |
| Kimberly A Browning | Nurse Practitioner | St Vincent Medical Group | 3025 Fountain Dr, Suite 100, Conway, AR 72034-3690 |
| Teresa M Whitwell | Nurse Practitioner | St Vincent Medical Group | 4000 Richards Rd, Suite B, North Little Rock, AR 72117-2939 |
| Whitney N Reed | Nurse Practitioner | St Vincent Medical Group | St Vincent Medical Clinic- Lonoke, 130 Jf Blvd, Lonoke, AR 72086-9365 |
| Lara Sanders | Nurse Practitioner | St Vincent Medical Group | 7709 Hwy 107, Sherwood, AR 72120-4661 |
| Vyjayanthi Ganga | Internal Medicine | St Vincent Medical Group | 2500 E 6th St, Health Clinic East, Little Rock, AR 72202-3008 |
| Ali Raja | Neurosurgery | St Vincent Medical Group | 6020 Warden Rd, 100 Arkansas Neuroscience Institute, Sherwood, AR 72120-6068 |
| Paul E Valentin-stone | Internal Medicine | St Vincent Medical Group | 1401 Braden St, Jacksonville, AR 72076-3720 |
| Rayburn F Rego | Gastroenterology | St Vincent Medical Group | 417 N University Ave, Little Rock, AR 72205-3108 |
| Thomas R Braswell | Family Medicine | St Vincent Medical Group | St Vincent Medical Clinic-scott, 15111 Highway 165, Scott, AR 72142 |
| Street Address |
15033 HWY 165 |
| City | SCOTT |
| State | AR |
| Zip | 72142-9555 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas R Braswell | Family Medicine | St Vincent Medical Group | St Vincent Medical Clinic-scott, 15111 Highway 165, Scott, AR 72142 |
| Aleobe Eruemulor | Family Medicine | St Vincent Medical Group | St Vincent Medical Clinic-scott, 15111 Highway 165, Scott, AR 72142 |
| City | SCOTT |
| Zip Code | 72142 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | SCOTT + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Lori Fawbush.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.