Active NPI
Jacqueline Thomas, MHPP
- Case Manager/Care Coordinator
- Earle, AR
National Provider Identifier
1043589930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 320 Lee Ave
Earle, AR 72331-2159 - Phone
- (870) 792-7769
- NPI assigned
- Dec 21, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
320 Lee Ave
Earle, AR 72331-2159
Mailing address
703 Calvin Avery Dr
West Memphis, AR 72301-6501
Phone (870) 732-1878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Strategies of Arkansas | Past | Accepting new patients | |
| Kids for the Future, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinical Child & Adolescent Psychologist
- West Memphis, AR
- NPI 1770719106
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Earle, AR
- NPI 1417193350
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324425600000",
"number": "1043589930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 CALVIN AVERY DR",
"city": "WEST MEMPHIS",
"state": "AR",
"postal_code": "723016501",
"telephone_number": "870-732-1878",
"fax_number": "870-702-7111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 LEE AVE",
"city": "EARLE",
"state": "AR",
"postal_code": "723312159",
"telephone_number": "870-792-7769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "JACQUELINE",
"name_prefix": "Mrs.",
"credential": "MHPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-21",
"last_updated": "2011-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Earle, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.