Individual provider Active NPI

Madison Birdno

  • Family Health Clinical Nurse Specialist
  • Jonesboro, AR
National Provider Identifier
1114534369
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
License
213142 Issued in AR
Practice address
303 E Matthews Ave Ste 202
Jonesboro, AR 72401-3120
Phone
(870) 207-7566
NPI assigned
Sep 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X 213142 AR Primary

Addresses

Primary practice location

303 E Matthews Ave Ste 202
Jonesboro, AR 72401-3120

Mailing address

303 E Matthews Ave Ste 202
Jonesboro, AR 72401-3120
Phone (870) 207-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210521000241 AR Practitioner - Certified Clinical Nurse Specialist (CNS) 3779982848 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
213142ARMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Hospital Inc. CurrentSince Mar 1, 2021 Accepting new patients
St Bernards Hospital Inc CurrentSince Jun 11, 2022 Accepting new patients
St. Bernards Hospital Inc CurrentSince Mar 1, 2021 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients

Locations

303 E Matthews Ave
Ste 202
Jonesboro, AR 72401
Phone (870) 207-7555

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

Interoperability endpoints

  • Direct secure messaging: mnbirdno2@sbpc.medalliesdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1114534369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E MATTHEWS AVE STE 202",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013120",
            "telephone_number": "870-207-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E MATTHEWS AVE STE 202",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013120",
            "telephone_number": "870-207-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRDNO",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "AR",
            "license": "213142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.