Individual provider Active NPI

Jason R Casey, M.D.

  • Internal Medicine Physician
  • Jonesboro, AR
National Provider Identifier
1164401394
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C7674 Issued in AR
Practice address
3202 Brentway LN
Jonesboro, AR 72404-8235
Phone
(870) 819-1564
NPI assigned
Jan 16, 2006
Last updated
Oct 26, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C7674 AR Primary

Addresses

Primary practice location

3202 Brentway LN
Jonesboro, AR 72404-8235

Mailing address

3202 Brentway LN
Jonesboro, AR 72404-8235
Phone (870) 819-1564

Other identifiers 2

IdentifierTypeStateIssuer
121764001MedicaidAR
146063002MedicaidAR

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231030000552 AR Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5698954675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C7674ARMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1164401394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 BRENTWAY LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048235",
            "telephone_number": "870-819-1564",
            "fax_number": "870-933-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 BRENTWAY LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048235",
            "telephone_number": "870-819-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "C7674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121764001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146063002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.