Individual provider Active NPI

Tanika D Jarrett, APRN

  • Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1285198507
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A005966 Issued in AR
Practice address
249 S Main St
Jonesboro, AR 72401-2908
Phone
(870) 336-1793
Fax
(870) 336-1786
NPI assigned
Jan 31, 2019
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A005966 AR
Nurse Practitioner 363L00000X A005966 AR Primary

Addresses

Primary practice location

249 S Main St
Jonesboro, AR 72401-2908

Mailing address

249 S Main St
Jonesboro, AR 72401-2908
Phone (870) 336-1793

Other identifiers 1

IdentifierTypeStateIssuer
232220758MedicaidAR

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.downtownmedicineandspa.com

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1285198507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 S MAIN ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724012908",
            "telephone_number": "870-336-1793",
            "fax_number": "870-336-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 S MAIN ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724012908",
            "telephone_number": "870-336-1793",
            "fax_number": "870-336-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRETT",
        "first_name": "TANIKA",
        "middle_name": "D",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005966",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A005966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232220758",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.downtownmedicineandspa.com",
            "affiliation": "N",
            "address_1": "249 S Main St",
            "city": "Jonesboro",
            "state": "AR",
            "country_code": "US",
            "postal_code": "724012908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.