Active NPI
Jaime Marie Holthaus, APRN
- Family Nurse Practitioner
- Bentonville, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A005688
- Practice address
- 3101 SE 14TH St
Bentonville, AR 72712-4900 - Phone
- (479) 986-6090
- NPI assigned
- Jun 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A005688 | AR | Primary |
Addresses
Primary practice location
3101 SE 14TH St
Bentonville, AR 72712-4900
Mailing address
713 Coulter Rd
Sherwood, AR 72120-5917
Phone (501) 864-9460
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
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
Practice addresses (Care Compare)
3101 SE 14TH St
Bentonville, AR 72712-4900
Phone (479) 631-2100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients | |
| Mercy Northwest Arkansas Ambulatory Services LLC | Current | Accepting new patients |
Locations
3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100
1000 SE 13th Ct
Bentonville, AR 72712
Phone (479) 273-9056
2012 S Promenade Blvd
Rogers, AR 72758
Phone (479) 616-1485
2708 S Rife Medical Ln
Ste T30
Rogers, AR 72758
Phone (479) 338-3999
Interoperability endpoints
- jholthaus987301@directc.mercy.net
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Rogers, AR
- NPI 1265490916
-
- Urgent Care Clinic/Center
- Springdale, AR
- NPI 1366922320
-
- Orthopaedic Surgery Physician
- Rogers, AR
- NPI 1063835908
-
- Endocrinology, Diabetes & Metabolism Physician
- Rogers, AR
- NPI 1770087371
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mercy Hospital Northwest Arkansas
- General Acute Care Hospital
- Rogers, AR
- NPI 1316902414
-
- Home Health Agency
- Rogers, AR
- NPI 1942265160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529884800000",
"number": "1194210070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 COULTER RD",
"city": "SHERWOOD",
"state": "AR",
"postal_code": "721205917",
"telephone_number": "501-864-9460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 SE 14TH ST",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727124900",
"telephone_number": "479-986-6090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLTHAUS",
"first_name": "JAIME",
"middle_name": "MARIE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-25",
"last_updated": "2018-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A005688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.