Individual provider Active NPI

Destiny Yvonne Frazier

  • Family Nurse Practitioner
  • Jacksonville, AR
National Provider Identifier
1164175303
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
218640 Issued in AR
Practice address
1012 Puritan Dr
Jacksonville, AR 72076-6081
Phone
(501) 313-8119
NPI assigned
Jan 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 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 218640 AR Primary

Addresses

Primary practice location

1012 Puritan Dr
Jacksonville, AR 72076-6081

Mailing address

1012 Puritan Dr
Jacksonville, AR 72076-6081

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
I20220602002821 AR Practitioner - Nurse Practitioner 2062890049 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1010 N Ctr St
Lonoke, AR 72086-2005
Phone (501) 438-8075

20 Wilson Farm Rd
Greenbrier, AR 72058-9310
Phone (501) 679-8970

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218640ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Team of Arkansas Physicians, LLC CurrentSince Apr 21, 2025 Accepting new patients
Urgent Team of Arkansas Physicians, LLC CurrentSince Apr 21, 2025 Accepting new patients
Access Medical Clinic Arkansas LTC LLC CurrentSince Apr 5, 2025 Accepting new patients

Locations

49 Highway 62 412
Ash Flat, AR 72513
Phone (573) 718-2570

824 Military Rd
Benton, AR 72015
Phone (501) 574-3019

4196 Highway 62 412
#A
Hardy, AR 72542
Phone (870) 856-2100

1813 T P White Dr
Jacksonville, AR 72076
Phone (501) 241-4510

511 W Main St
Russellville, AR 72801
Phone (479) 223-5130

106 N Van Buren St
Weiner, AR 72479
Phone (870) 605-0014

Interoperability endpoints

  • Direct secure messaging: destiny.frazier.1@29938.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1164175303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 PURITAN DR",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720766081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 PURITAN DR",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720766081",
            "telephone_number": "501-313-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "DESTINY",
        "middle_name": "YVONNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "218640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, AR

Sources for this page

Verify at the official NPI Registry.