SOUTNAKHON PHANDANOUVONG (APRN) – Family Nurse Practitioner, NPI 1780273250
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,434 NURSE PRACTITIONER in AR
Provider Addresses for SOUTNAKHON PHANDANOUVONG (APRN)
5728 KIBLER RD
VAN BUREN, AR 729567576
Phone: (479) 459-0046
Type: Mailing
4300 GRAND AVE
FORT SMITH, AR 729047028
Phone: (479) 208-4601
Type: Location
1101 SUNNYSIDE RD
ALMA, AR 729217301
Phone: (479) 459-0046
Type: Mailing
421 N MAIN ST
MULBERRY, AR 729478574
Phone: (479) 997-1484
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $485.
Total Amount is formed as General ($485) + Research ($0) + Ownership ($0) = $485.
Last reported payment date: 2024-11-07 • Largest payer in this snapshot: ABBVIE INC. ($438).
Total Amount
$485
General + Research + Ownership
Payments
11
Total payment records
General Amount
$485
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $438 |
| Gilead Sciences, Inc. | $30 |
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $18 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-06-05
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210209002792 | I | Nurse Practitioner | AR | TBD |
| I20250605000483 | I | Nurse Practitioner | OK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 93 | 64 | $0 |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 74 | 59 | $0 |
| 83036 | Hemoglobin a1c level | 69 | 44 | $0 |
| 81003 | Automated urinalysis test | 34 | 26 | $0 |
| 82044 | Urine microalbumin (protein) analysis | 20 | 20 | $0 |
Insurance plans in this area (ZIP 72956)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AR | |
| Internal Medicine, Critical Care (Intensivists), Pulmonary Disease | AR | |
| Nurse Practitioner | AR |
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