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ST MARY'S PHYSICIAN SERVICES LLC
NPI 1124084991
General Practice in Russellville, AR

Active since April 21, 2006
101 SKYLINE DR, RUSSELLVILLE, AR 72801(479) 968-2345(479) 890-2497 Get Directions Write a Review

NPPES record last updated: September 26, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 26, 2024, Feb 7, 2023, Jun 16, 2019 (3 updates tracked since 2019).

About St Mary's Physician Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST MARY'S PHYSICIAN SERVICES LLC (NPI 1124084991) is a healthcare organization registered as a general practice in Russellville, Arkansas and active in the NPI registry since April 2006. The organization lists Charlotte Lawrence, Secretary, as its authorized official.

NPPES Registry Identity

NPI1124084991
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameST MARY'S PHYSICIAN SERVICES LLC
Location Address101 SKYLINE DRRussellville, AR 72801-3363
Mailing Address101 Skyline DrRussellville, AR 72801-3363 · (479) 968-2345
Phone(479) 968-2345
Fax(479) 890-2497
Organization SubpartNo
Authorized OfficialCharlotte LawrenceSecretary · (615) 920-7000
Enumeration DateApril 21, 2006
Last NPPES UpdateSeptember 26, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 26, 2024
✔ NPI 1124084991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedInternal MedicineTaxonomy 207R00000X
101 SKYLINE DR, Russellville, AR 72801
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Other Identifiers 2

OtherDA8026Railroad Medicare Ptan
Medicaid152955002AR

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

St Mary's Physician Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

136

Medicare enrollment records show 136 clinicians reassign Medicare billing to St Mary's Physician Services LLC, which bills Medicare for the services they deliver. Of these, 31 practice at this address and 67 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 14

Nurse Practitioner25
Internal Medicine24
Family Practice22
General Surgery17
Obstetrics/Gynecology16
Cardiovascular Disease (Cardiology)9
Pediatric Medicine8
Interventional Cardiology6
6 other specialties9

Nearest to this location (20)

See all 136
Ashley Baker, APRN
Nurse Practitioner
NPI 1891294443
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Christina Bartlett, M.D.
Pediatric Medicine
NPI 1649484452
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOSSame address
Homer Beavers, MD
Internal Medicine
NPI 1982660742
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Michael Bell, MD
General Surgery
NPI 1407812589
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Dennis Berner, MD
Internal Medicine
NPI 1760448534
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOSSame address
Zbigniew Beyga, MD
General Surgery
NPI 1699743831
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Jonathan Brixey, M.D.
Internal Medicine
NPI 1629336078
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Jefferson Cartwright, M.D.
Orthopedic Surgery
NPI 1285678300
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Janet Corbett, D.O.
Family Practice
NPI 1104838945
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Erin Dodge, APRN
Nurse Practitioner
NPI 1245683895
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Carey Ellis Laffoon, APRN
Nurse Practitioner
NPI 1720284318
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOSSame address
Kendra Fletcher, APRN
Nurse Practitioner
NPI 1912486648
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOSSame address
Mateo Guarderas Ribadeneira, M.D.
General Surgery
NPI 1487004990
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Rick Harrison, MD
Pediatric Medicine
NPI 1316903669
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOSSame address
Tessa Henry, MD
General Surgery
NPI 1801424254
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Keith Ison, MD
Internal Medicine
NPI 1497711279
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Chadwick Masters, M.D.
Pediatric Medicine
NPI 1326339557
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Michael Mcalister, M.D.
Family Practice
NPI 1629398276
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
Barry Mccraw, MD
Pediatric Medicine
NPI 1831155191
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOSSame address
Fauzia Qadir, MD
Family Practice
NPI 1982616231
101 SKYLINE DR
Russellville, AR 72801
(479) 968-2345
✔ PECOS✔ Accepts MedicareSame address
See all 136 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St Mary's Physician Services LLC's NPI number?

The NPI number for St Mary's Physician Services LLC is 1124084991. It was assigned to this organization in the NPPES registry on April 21, 2006.

Where is St Mary's Physician Services LLC located?

St Mary's Physician Services LLC is located at 101 Skyline Dr, Russellville, AR 72801. The listed phone number is (479) 968-2345.

What is St Mary's Physician Services LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is St Mary's Physician Services LLC enrolled in Medicare?

Yes. St Mary's Physician Services LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through St Mary's Physician Services LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 136 clinicians in 14 Medicare specialties reassign their Medicare billing to St Mary's Physician Services LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (25), Internal Medicine (24) and Family Practice (22). Of these, 31 practice at this address and 67 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does St Mary's Physician Services LLC accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Alabama and 2 other insurers list St Mary's Physician Services LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for St Mary's Physician Services LLC was last updated on September 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.