Individual provider Active NPI

Jayna J. Monical, FNP-BC

  • Family Nurse Practitioner
  • Centerton, AR
National Provider Identifier
1124343074
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
222403 Issued in AR
Practice address
1225 E Centerton Blvd
Centerton, AR 72719-1225
Phone
(479) 795-1301
Fax
(479) 795-1304
NPI assigned
Apr 5, 2010
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2010009034 MO
Family Nurse Practitioner 363LF0000X 222403 AR Primary

Addresses

Primary practice location

1225 E Centerton Blvd
Centerton, AR 72719-1225

Mailing address

1225 E Centerton Blvd
Centerton, AR 72719-1225
Phone (479) 795-1301

Other practice location 1

802 Monroe St
Saint Joseph, MO 64505-1998
Phone (816) 261-8319

Other practice location 2

1510 Duncan St
Saint Joseph, MO 64503-2600
Phone (816) 271-8850

Other identifiers 2

IdentifierTypeStateIssuer
1124343074MedicaidMO
200641220AMedicaidKS

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
I20230113002564 AR Practitioner - Nurse Practitioner 3476681693 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010009034MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jan 3, 2023 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jan 3, 2023 Accepting new patients

Locations

1 Mercy Way
Ste 20
Bella Vista, AR 72714
Phone (479) 802-5555

2900 SE Moberly Ln
Bentonville, AR 72712
Phone (479) 273-1550

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

1225 E Centerton Blvd
Centerton, AR 72719
Phone (479) 795-1301

325 S 6th Pl
Lowell, AR 72745
Phone (479) 636-9234

200 Carr St
Pea Ridge, AR 72751
Phone (479) 488-6415

2708 S Rife Medical Ln
Ste 130
Rogers, AR 72758
Phone (479) 338-5555

4600 Mercy Ln
Springdale, AR 72762
Phone (479) 338-2911

4600 Mercy Ln
Ste 140
Springdale, AR 72762
Phone (479) 347-3905

4780 Elm Springs Rd
Springdale, AR 72762

Interoperability endpoints

  • Direct secure messaging: jayna.monical@direct.mymlc.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1124343074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E CENTERTON BLVD",
            "city": "CENTERTON",
            "state": "AR",
            "postal_code": "727191225",
            "telephone_number": "479-795-1301",
            "fax_number": "479-795-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E CENTERTON BLVD",
            "city": "CENTERTON",
            "state": "AR",
            "postal_code": "727191225",
            "telephone_number": "479-795-1301",
            "fax_number": "479-795-1304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 Monroe St",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645051998",
            "country_code": "US",
            "telephone_number": "816-261-8319",
            "fax_number": "816-671-9321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1510 Duncan St",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645032600",
            "country_code": "US",
            "telephone_number": "816-271-8850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONICAL",
        "first_name": "JAYNA",
        "middle_name": "J.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2010009034",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "222403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124343074",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200641220A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerton, AR

Sources for this page

Verify at the official NPI Registry.