Individual provider Active NPI

Shayna Nunn

  • Family Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1174048201
Registry record updated Aug 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A005319 Issued in AR
Practice address
201 E Oak Ave
Jonesboro, AR 72401-4163
Phone
(870) 935-6729
NPI assigned
Aug 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2017

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 A005319 AR Primary

Addresses

Primary practice location

201 E Oak Ave
Jonesboro, AR 72401-4163

Mailing address

759 Highway 168 W
Bono, AR 72416-9224

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
I20171002002568 AR Practitioner - Nurse Practitioner 8325313380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Bernards Physician Clinics IncGroup PAC ID 7012311269, 211 clinicians

Practice addresses (Care Compare)

1005 E Matthews Ave
Jonesboro, AR 72401-4308
Phone (870) 935-1242

1007 E Matthews Ave
Jonesboro, AR 72401-4308
Phone (870) 336-0472

201 E Oak Ave
Jonesboro, AR 72401-4163
Phone (870) 935-6729

Hospital & facility affiliations

  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020
  • St Bernards Five Rivers Medical Center Hospital, Pocahontas, AR, CCN 040779

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005319ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Physician Clinics Inc Current Accepting new patients
St Bernards Physician Clinics, Inc. CurrentSince Mar 1, 2024 Accepting new patients
St Bernards Physician Clinics Inc CurrentSince Mar 1, 2024 Accepting new patients

Locations

1005 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-1242

201 E Oak Ave
Jonesboro, AR 72401

Interoperability endpoints

  • Direct secure messaging: slnunn1@sbpc.medalliesdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502236800000",
    "number": "1174048201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 HIGHWAY 168 W",
            "city": "BONO",
            "state": "AR",
            "postal_code": "724169224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E OAK AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014163",
            "telephone_number": "870-935-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNN",
        "first_name": "SHAYNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2017-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.