Individual provider Active NPI

Jordan Scott Vallieres

  • Family Nurse Practitioner
  • Siloam Springs, AR
National Provider Identifier
1144708058
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
223337 Issued in AR
Practice address
451 S Holly St
Siloam Springs, AR 72761-3018
Phone
(479) 524-3141
NPI assigned
Aug 2, 2018
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 223337 AR Primary

Addresses

Primary practice location

451 S Holly St
Siloam Springs, AR 72761-3018

Mailing address

614 E Emma Ave Ste 300
Springdale, AR 72764-4469
Phone (479) 751-7417

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
I20230731003610 AR Practitioner - Nurse Practitioner 3577807049 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Francis House Nwa, Inc.Group PAC ID 0042262495, shared by 27 NPIs, 67 clinicians

Practice addresses (Care Compare)

451 S Holly St
Siloam Springs, AR 72761-3018
Phone (479) 524-3141

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis House Nwa, Inc CurrentSince Apr 29, 2024 Accepting new patients
St Francis House Nwa, Inc CurrentSince Apr 29, 2024 Accepting new patients
St Francis House Nwa, Inc CurrentSince Dec 27, 2024 Accepting new patients
St Francis House Nwa, Inc Current Accepting new patients
St. Francis House Nwa, Inc. Past Accepting new patients

Locations

643 E 3rd St
Gentry, AR 72734
Phone (479) 736-2213

451 S Holly St
Siloam Springs, AR 72761
Phone (479) 524-3141

614 E Emma Ave
Ste 300
Springdale, AR 72764
Phone (479) 751-4898

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGBFAD

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1144708058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E EMMA AVE STE 300",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644469",
            "telephone_number": "479-751-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 S HOLLY ST",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727613018",
            "telephone_number": "479-524-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLIERES",
        "first_name": "JORDAN",
        "middle_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-02",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "223337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Siloam Springs, AR

Sources for this page

Verify at the official NPI Registry.