Jack Zepeda, MD, MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E-13916 Issued in AR

Practice address

1301 S E St
Fort Smith, AR 72901-4716

Phone

(479) 785-2431

NPI assigned

Nov 3, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR, FL, AL3 enrollments

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 3

Specialty

Emergency Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians

Flowers HB Medical Services LLCGroup PAC ID 6305290990, 139 clinicians

Santa Rosa HB Medical Services LLCGroup PAC ID 4284089335, 35 clinicians

Ies Florida PLLCGroup PAC ID 8921485004, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Englewood Hospital Hospital, Englewood, FL, CCN 100267
• Adventhealth Port Charlotte Hospital, Port Charlotte, FL, CCN 100077
• Flowers Hospital Hospital, Dothan, AL, CCN 010055
• Santa Rosa Medical Center Hospital, Milton, FL, CCN 100124
• Manatee Memorial Hospital Hospital, Bradenton, FL, CCN 100035

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 31)

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3809/brand/1/csg/1/fhir/r4

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.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Flowers HB Medical Services LLC

  • Emergency Medicine Physician
  • Dothan, AL
  • NPI 1972283828

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Ies Florida PLLC

  • Emergency Medicine Physician
  • Venice, FL
  • NPI 1124788716

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Santa Rosa HB Medical Services LLC

  • Emergency Medicine Physician
  • Milton, FL
  • NPI 1982384988

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Arkansas Emergency Staffing Solutions, Inc

  • Emergency Medicine Physician
  • Hope, AR
  • NPI 1275774630

  Single Specialty

  Medicare reassignment NPD
• Ess Hospitalist LLC

  • Hospitalist Physician
  • Crossett, AR
  • NPI 1881967305

  Single Specialty

  Medicare reassignment NPD
• Ess of Fordyce LLC

  • Emergency Medicine Physician
  • Fordyce, AR
  • NPI 1821547977

  Single Specialty

  Medicare reassignment NPD
• Hospital Care Consultants of Fordyce LLC

  • Hospitalist Physician
  • Fordyce, AR
  • NPI 1316497464

  Single Specialty

  Medicare reassignment NPD
• Mercy Hospital Booneville

  • Certified Registered Nurse Anesthetist
  • Booneville, AR
  • NPI 1083004733

  Single Specialty

  Medicare reassignment NPD
• Mercy Hospital Booneville

  • Critical Access Hospital
  • Booneville, AR
  • NPI 1992133714
  Medicare reassignment NPD
• Mercy Hospital Ozark

  • Critical Access Hospital
  • Ozark, AR
  • NPI 1275504128
  Medicare reassignment NPD
• Mercy Hospital Ozark

  • Emergency Care Clinic/Center
  • Ozark, AR
  • NPI 1881642767

  Single Specialty

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventhealth Port Charlotte Inc

  • General Acute Care Hospital
  • Port Charlotte, FL
  • NPI 1760299093
  Care Compare affiliation
• Englewood Community Hospital, Inc.

  • General Acute Care Hospital
  • Englewood, FL
  • NPI 1639122864
  Care Compare affiliation
• Hma Santa Rosa Medical Center LLC

  • General Acute Care Hospital
  • Milton, FL
  • NPI 1528015302
  Care Compare affiliation
• Manatee Memorial Hospital L P

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1760472799
  Care Compare affiliation
• Triad of Alabama LLC

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1801830500
  Care Compare affiliation

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

{
    "created_epoch": "1541203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1184192510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8100",
            "fax_number": "850-863-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S E ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014716",
            "telephone_number": "479-785-2431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Mar Walt Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325476707",
            "country_code": "US",
            "telephone_number": "850-863-6600",
            "fax_number": "850-862-0977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEPEDA",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-03",
        "last_updated": "2022-05-17",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2018036941",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-13916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maha Zafar, MBBS/MD
• Savannah Star Zappa-Varner, QBHP
• Roya Zarepour, APN
• Holley Zarlingo, LPC
• Tracey Leigh Zeiner, OTD, OTR/L
• Zhi Zheng, DMD
• Ayhan A Zia, MD
• Aubrey Ziegler, M.D.
• Leslie Thompson Ziegler, M.D.
• Timothy Zimmerman, MD

• Family Medicine Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.