Individual provider Active NPI

Mariah Jean Jackson-Arnett, MD

  • Emergency Medicine Physician
  • Corbin, KY
National Provider Identifier
1023758760
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
60342 Issued in KY
Practice address
1 Trillium Way
Corbin, KY 40701-8426
Phone
(606) 528-1212
NPI assigned
Mar 30, 2022
Last updated
Jun 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X GA
Emergency Medicine Physician 207P00000X 60342 KY Primary

Addresses

Primary practice location

1 Trillium Way
Corbin, KY 40701-8426

Mailing address

743 Spring St NE Ste 701
Gainesville, GA 30501-3715
Phone (770) 219-8730

Other practice location 1

743 Spring St NE Ste 701
Gainesville, GA 30501-3715
Phone (770) 219-8730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250711001343 KY Practitioner - Emergency Medicine 6507371382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Kentucky College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Fairview Emergency Physicians LLCGroup PAC ID 5799034799, 40 clinicians

Practice addresses (Care Compare)

2501 Kentucky Ave
Paducah, KY 42003-3813
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
West Fairview Emergency Physicians LLC Emergency Medicine CurrentSince Mar 18, 2026 Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

2501 Kentucky Ave
Paducah, KY 42003
Phone (270) 575-2180

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 985-7114

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1023758760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE STE 701",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TRILLIUM WAY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018426",
            "telephone_number": "606-528-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "743 Spring St NE Ste 701",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013715",
            "country_code": "US",
            "telephone_number": "770-219-8730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON-ARNETT",
        "first_name": "MARIAH",
        "middle_name": "JEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "60342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.