Individual provider Active NPI

Jeanette Cusan Piker, APRN

  • Adult Health Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1124269642
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A006004 Issued in AR
Practice address
201 E Oak Ave
Jonesboro, AR 72401-4163
Phone
(870) 935-6729
NPI assigned
Mar 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A006004 AR Primary
Gerontology Nurse Practitioner 363LG0600X A006004 AR
Psychiatric/Mental Health Registered Nurse 163WP0808X R72300 AR
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X E-11988 AR

Addresses

Primary practice location

201 E Oak Ave
Jonesboro, AR 72401-4163

Mailing address

201 E Oak Ave
Jonesboro, AR 72401-4163
Phone (870) 935-6729

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
I20210430000222 AR Practitioner - Nurse Practitioner 8820407000 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R72300ARMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 5, 2021 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 5, 2021 Accepting new patients

Locations

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

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.

NPI Registry JSON

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1124269642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E OAK AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014163",
            "telephone_number": "870-935-6729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E OAK AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014163",
            "telephone_number": "870-935-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKER",
        "first_name": "JEANETTE",
        "middle_name": "CUSAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-12",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "A006004",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "A006004",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AR",
            "license": "R72300",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AR",
            "license": "E-11988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.