Individual provider Active NPI

Heather Rodriguez Smith, APRN

  • Family Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1255735551
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
229840 Issued in AR
Practice address
4802 E Johnson Ave
Jonesboro, AR 72405-8413
Phone
(870) 936-8000
Fax
(870) 934-3628
NPI assigned
Oct 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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 229840 AR Primary

Addresses

Primary practice location

4802 E Johnson Ave
Jonesboro, AR 72405-8413

Mailing address

PO Box 1960
Jonesboro, AR 72403-1960
Phone (870) 936-8000

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
I20240831000621 AR Practitioner - Nurse Practitioner 7517406770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Arkansas Clinic Charitable Foundation, Inc.Group PAC ID 2961547526, 294 clinicians

Practice addresses (Care Compare)

4802 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000

Hospital & facility affiliations

  • Baptist Memorial Hospital Jonesboro, Inc. Hospital, Jonesboro, AR, CCN 040118

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Arkansas Clinic Charitable Foundation, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Current Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Past Accepting new patients

Locations

4802 E Johnson Ave
Jonesboro, AR 72405
Phone (901) 227-9820

1111 Windover Rd
Jonesboro, AR 72401
Phone (870) 935-5432

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.

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": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1255735551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1960",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031960",
            "telephone_number": "870-936-8000",
            "fax_number": "870-934-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 E JOHNSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724058413",
            "telephone_number": "870-936-8000",
            "fax_number": "870-934-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HEATHER",
        "middle_name": "RODRIGUEZ",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "229840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.