Individual provider Active NPI

Jennifer Kesterson, APRN

  • Family Nurse Practitioner
  • Mena, AR
National Provider Identifier
1346789724
Registry record updated May 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A005043 Issued in AR
Practice address
136 Health Park Dr
Mena, AR 71953-9072
Phone
(888) 710-8220
Fax
(866) 573-0761
NPI assigned
Feb 17, 2017
Last updated
May 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2023

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 A005043 AR Primary

Addresses

Primary practice location

136 Health Park Dr
Mena, AR 71953-9072

Mailing address

PO Box 1848
Mena, AR 71953-1841
Phone (479) 437-3449

Other identifiers 1

IdentifierTypeStateIssuer
219903758MedicaidAR

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
I20170512001573 AR Practitioner - Nurse Practitioner 1557648946 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Connections Incorporated CurrentSince Nov 17, 2021 Accepting new patients
Healthy Connections Incorporated Current Accepting new patients
Healthy Connections Inc CurrentSince Nov 17, 2021 Accepting new patients
Healthy Connections Inc Past Accepting new patients

Locations

1206 W Collin Raye Dr
De Queen, AR 71832
Phone (870) 642-3317

208 McAuley Ct
Ste B
Hot Springs, AR 71913

3604 Central Ave
Ste D
Hot Springs, AR 71913
Phone (501) 318-0646

1100 N University Ave
Ste 200
Little Rock, AR 72207
Phone (501) 209-4040

900 Martin Luther King Blvd
Malvern, AR 72104
Phone (501) 332-7525

136 Health Park Dr
Mena, AR 71953
Phone (501) 624-7700

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, 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": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685145600000",
    "number": "1346789724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719531841",
            "telephone_number": "479-437-3449",
            "fax_number": "479-243-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 HEALTH PARK DR",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719539072",
            "telephone_number": "888-710-8220",
            "fax_number": "866-573-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTERSON",
        "first_name": "JENNIFER",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-17",
        "last_updated": "2023-05-27",
        "certification_date": "2023-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219903758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mena, AR

Sources for this page

Verify at the official NPI Registry.