Soutnakhon Phandanouvong, APRN in Fort Smith, AR

Soutnakhon Phandanouvong, APRN is a medicare enrolled "Nurse Practitioner - Family" in Fort Smith, Arkansas. She graduated from nursing school in 2024 and has 2 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Urgent Team Of Arkansas Physicians Llc, Arkansas Lung Center Pllc, Arkansas Lung Center Pllc and her current practice location is 4300 Grand Ave, Fort Smith, Arkansas. You can reach out to her office (for appointments etc.) via phone at (479) 208-4601.

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
	4300 Grand Ave, Fort Smith, AR 72904-7028
	(479) 208-4601
	Not Available

Map and Direction

Provider's Profile

Full Name	Soutnakhon Phandanouvong
Gender	Female
Speciality	Nurse Practitioner
Experience	2 Years
Location	4300 Grand Ave, Fort Smith, Arkansas
Accepts Medicare Assignments	Yes. 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 2024

NPI Data:

NPI Number: 1780273250
Provider Enumeration Date: 01/11/2021
Last Update Date: 06/05/2025

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.

Identifier	Type	State	Issuer
1780273250	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	214525 (Arkansas)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Mercy Hospital Fort Smith	Fort smith, AR	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Urgent Team Of Arkansas Physicians Llc	1850539198	134
Arkansas Lung Center Pllc	2769838812	3
Arkansas Lung Center Pllc	2769838812	3

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 Name	River Valley Primary Care Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952349003 PECOS PAC ID: 0042274276 Enrollment ID: O20050503001398

Entity Name	Urgent Team Of Arkansas Physicians Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1992041370 PECOS PAC ID: 1850539198 Enrollment ID: O20130529000209

Entity Name	Mercy Northwest Arkansas Ambulatory Services, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366922320 PECOS PAC ID: 3779827993 Enrollment ID: O20181129000273

Entity Name	Arkansas Lung Center Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1447036108 PECOS PAC ID: 2769838812 Enrollment ID: O20231025001727

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 Address	Practice Location Address
Soutnakhon Phandanouvong, APRN 5728 Kibler Rd, Van Buren, AR 72956-7576 Ph: (479) 459-0046	Soutnakhon Phandanouvong, APRN 4300 Grand Ave, Fort Smith, AR 72904-7028 Ph: (479) 208-4601

Reviews and Comments

Nurse Practitioner Nurses in Fort Smith, AR

Valentina Nastasi, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7600 Rogers Ave, Fort Smith, AR 72903 Phone: 479-226-8340
Mrs. Tonya Renea Allen, APRN, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3112 S 70th St, Fort Smith, AR 72903 Phone: 479-452-8600
Mandi T Williams, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7217 Cameron Park Dr, Fort Smith, AR 72903 Phone: 479-831-6007 Fax: 479-782-1242
Tracy Lynn Fisher, APN, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4900 Kelley Hwy, Fort Smith, AR 72904 Phone: 479-785-5700 Fax: 479-785-5708
Mrs. Athena Frangos-pasley, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1500 Dodson Ave, Fort Smith, AR 72901 Phone: 479-709-6850
Mrs. Gayla Denise Johnson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7301 Rogers Ave, Fort Smith, AR 72903 Phone: 479-484-6000
Dabney Herrold, MSN, APRN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3420 S 74th St, Fort Smith, AR 72903 Phone: 479-573-3740

Soutnakhon Phandanouvong, APRN - Medicare Nurse Practitioner in Fort Smith, AR