Jourdan Quinn, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A005913 Issued in AR

Practice address

11300 Cantrell Rd Ste 204
Little Rock, AR 72212

Phone

(501) 228-7662

NPI assigned

Apr 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revive Health and Wellness of Arkansas PLLCGroup PAC ID 9032599923, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Revive Health and Wellness of Arkansas, PLLC

  dba Revive Lifestyle Medicine

  • Family Nurse Practitioner
  • Little Rock, AR
  • NPI 1548935646
  Medicare reassignment Care Compare group NPD
• Housecall

  • Family Nurse Practitioner
  • Little Rock, AR
  • NPI 1487008157
  NPD (past)

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1174910210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 CANTRELL RD STE 204",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722121842",
            "telephone_number": "501-779-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 CANTRELL RD STE 204",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72212",
            "telephone_number": "501-228-7662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8114 Cantrell Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722272504",
            "country_code": "US",
            "telephone_number": "501-779-8554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINN",
        "first_name": "JOURDAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2023-08-01",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174910210",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quiklabs
• Mario Thelmo Quilao Jr., PT
• Michelle Lynn Quiles, MHPP
• Rodney Wayne Quillen
• Brian Dennis Quinn, M.D.
• D. Crickett Quinney, CRNA
• Kara Quinton
• Francis L Quito, DO
• Justin Chun Quon
• Saher Quraeshi, M.D.

• Family Nurse Practitioner in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.

Verify at the official NPI Registry.