Active NPI
Barbara Crystal Shackelford, APRN
- Family Nurse Practitioner
- Highland, AR
National Provider Identifier
1164907283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A005877
- Practice address
- 1995 Highway 62 412
Highland, AR 72542-9262 - Phone
- (870) 856-5620
- NPI assigned
- Sep 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A005877 | AR | |
| Acute Care Nurse Practitioner | 363LA2100X | A005877 | AR | |
| Family Nurse Practitioner | 363LF0000X | A005877 | AR | Primary |
Addresses
Primary practice location
1995 Highway 62 412
Highland, AR 72542-9262
Mailing address
58 Isleta Dr
Cherokee Village, AR 72529-5013
Phone (870) 955-1234
Other practice location 1
1995 Highway 62 412
Highland, AR 72542-9262
Phone (870) 856-5620
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 252346758 | Medicaid | AR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | GREENWAY | Direct |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200929002495 | AR | Practitioner - Nurse Practitioner | 9537588298 | Reassigns benefits to 1 organization |
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 Bernards Physician Clinics Inc
Practice addresses (Care Compare)
1995 Hwy 62 412
Highland, AR 72542-9262
Phone (870) 856-5620
Hospital & facility affiliations
- Elite Home Health
- St Bernards Medical Center
- White River Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A005877 | AR | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Bernards Physician Clinics Inc | Current | Accepting new patients | |
| St Bernards Physician Clinics Inc | Current | Accepting new patients | |
| St Bernards Physician Clinics Inc | Current | Accepting new patients | |
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Locations
1995 Highway 62 412
Highland, AR 72542
Phone (870) 856-4325
1005 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-1242
225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630
1001 W Parker Rd
Jonesboro, AR 72404
Phone (870) 336-1700
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.
-
- Diagnostic Radiology Physician
- Jonesboro, AR
- NPI 1780546051
-
- Internal Medicine Physician
- Jonesboro, AR
- NPI 1407577216
-
- Primary Care Clinic/Center
- Jonesboro, AR
- NPI 1275204307
Hospital & facility affiliations 18
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Salem, AR
- NPI 1295852366
-
- Orthopaedic Surgery Physician
- Batesville, AR
- NPI 1265821193
Hospital
-
- Pain Medicine (Anesthesiology) Physician
- Batesville, AR
- NPI 1558447599
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617753600000",
"number": "1164907283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 ISLETA DR",
"city": "CHEROKEE VILLAGE",
"state": "AR",
"postal_code": "725295013",
"telephone_number": "870-955-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1995 HIGHWAY 62 412",
"city": "HIGHLAND",
"state": "AR",
"postal_code": "725429262",
"telephone_number": "870-856-5620"
}
],
"practiceLocations": [
{
"address_1": "1995 Highway 62 412",
"address_purpose": "LOCATION",
"city": "Highland",
"state": "AR",
"postal_code": "725429262",
"country_code": "US",
"telephone_number": "870-856-5620",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHACKELFORD",
"first_name": "BARBARA",
"middle_name": "CRYSTAL",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-25",
"last_updated": "2021-04-07",
"certification_date": "2021-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "A005877",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "AR",
"license": "A005877",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A005877",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "252346758",
"state": "AR"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "GREENWAY",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1995 Highway 62 412",
"city": "Highland",
"state": "AR",
"country_code": "US",
"postal_code": "725429262",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Highland, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.