Active NPI
Syndey Jackson
- Counselor
- Rogers, AR
National Provider Identifier
1265853162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1200 W Walnut St
Ste 3100
Rogers, AR 72756-3521 - Phone
- (479) 631-9996
- Fax
- (479) 631-1782
- NPI assigned
- Dec 18, 2013
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1200 W Walnut St
Ste 3100
Rogers, AR 72756-3521
Mailing address
602 N Walton Blvd
Bentonville, AR 72712-4576
Phone (479) 464-1060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387324800000",
"number": "1265853162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 N WALTON BLVD",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727124576",
"telephone_number": "479-464-1060",
"fax_number": "479-271-6307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W WALNUT ST",
"address_2": "STE 3100",
"city": "ROGERS",
"state": "AR",
"postal_code": "727563521",
"telephone_number": "479-631-9996",
"fax_number": "479-631-1782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SYNDEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-18",
"last_updated": "2013-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.