Individual provider Active NPI

Jacob Didion, M.D.

  • Neurology Physician
  • Fort Smith, AR
National Provider Identifier
1104275239
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
E-14284 Issued in AR
Practice address
7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone
(479) 314-6000
Fax
(479) 314-5185
NPI assigned
Jun 9, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X LP03774 RI
Neurology Physician 2084N0400X E-14284 AR Primary

Addresses

Primary practice location

7301 Rogers Ave
Fort Smith, AR 72903-4100

Mailing address

10102 Stephens CT
Fort Smith, AR 72908-9339
Phone (479) 806-0240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210914002526 AR Practitioner - Neurology 3779878269 Reassigns benefits to 2 organizations
I20240619000630 MO Practitioner - Neurology 3779878269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Arkansas College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians
Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, 361 clinicians

Practice addresses (Care Compare)

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 237-4200

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-5175

Hospital & facility affiliations

  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062
  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
  • Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
  • Mercy Hospital Ada Hospital, Ada, OK, CCN 370020
  • Mercy Hospital Ardmore, Inc Hospital, Ardmore, OK, CCN 370047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-14284ARMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Sep 6, 2021 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Sep 6, 2021 Accepting new patients
Mercy Aco Clinical Services Inc Neurology CurrentSince Jun 10, 2022 Accepting new patients

Locations

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

7303 Rogers Ave
Ste 101
Fort Smith, AR 72903
Phone (479) 314-4620

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1104275239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10102 STEPHENS CT",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729089339",
            "telephone_number": "479-806-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034100",
            "telephone_number": "479-314-6000",
            "fax_number": "479-314-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDION",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "RI",
            "license": "LP03774",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AR",
            "license": "E-14284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.