Individual provider Active NPI

Sandee Miller Jacobs, APN

  • Acute Care Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1184954034
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
A03173ANP Issued in AR
Practice address
9101 Kanis Rd
Little Rock, AR 72205-6456
Phone
(501) 224-4001
NPI assigned
Dec 28, 2009
Last updated
Mar 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X A03173ANP AR Primary

Addresses

Primary practice location

9101 Kanis Rd
Little Rock, AR 72205-6456

Mailing address

9101 Kanis Rd
Little Rock, AR 72205-6456
Phone (501) 224-4001

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
I20170418000552 AR Practitioner - Nurse Practitioner 9234415704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christopher K Mocek MD PAGroup PAC ID 8224314216, 5 clinicians

Practice addresses (Care Compare)

9101 Kanis Rd
Suite 400
Little Rock, AR 72205-6450
Phone (501) 224-4001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
78.7
Improvement activities
40
Cost
74.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A03173ANPARMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher K Mocek MD PA CurrentSince Apr 3, 2017 Accepting new patients
River City Ministry of Pulaski County Past Accepting new patients

Locations

3121 N Reynolds Rd
Ste 1
Bryant, AR 72022

9101 Kanis Rd
Ste 400
Little Rock, AR 72205
Phone (501) 978-8618

1505 N Medical Dr
Stuttgart, AR 72160
Phone (870) 674-6702

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26991/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1261958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1184954034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056456",
            "telephone_number": "501-224-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056456",
            "telephone_number": "501-224-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "SANDEE",
        "middle_name": "MILLER",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-28",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A03173ANP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.