Jenny Alexis Blagg, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

213090 Issued in AR

Practice address

777 Jordan Dr
Monticello, AR 71655-5719

Phone

(870) 460-9001

Fax

(870) 412-4575

NPI assigned

Sep 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CHCGBD

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1336755891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MOHAWK ST",
            "city": "DUMAS",
            "state": "AR",
            "postal_code": "716392736",
            "telephone_number": "870-723-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 JORDAN DR",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716555719",
            "telephone_number": "870-460-9001",
            "fax_number": "870-412-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAGG",
        "first_name": "JENNY",
        "middle_name": "ALEXIS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "213090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jesse Bone, CNP
• Morgan Bone, OTR
• Allyson Kaye Bowman, DPT, ATC

• Family Nurse Practitioner in Monticello, AR
• Providers in Monticello, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.