Charlene Mae Jaques, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

229879 Issued in AR

Practice address

11112 Shumate Crossing Rd
Farmington, AR 72730-8792

Phone

(479) 856-9363

NPI assigned

Aug 1, 2024

Last updated

Dec 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elite Home Health Home health agency, Springdale, AR, CCN 047346

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Elevation Family Healthcare, PLLC

  • Family Medicine Physician
  • Farmington, AR
  • NPI 1174491468
  Medicare reassignment Authorized official
• Image Medical PLLC

  • Nurse Practitioner
  • Fayetteville, AR
  • NPI 1477341469
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  AR, Nurse Practitioner

  Medicare reassignment NPD
• Northwest Arkansas Senior Care Specialists, PLLC

  • Primary Care Nurse Practitioner
  • Fayetteville, AR
  • NPI 1326549783

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• LHCG Xlii, LLC

  dba Elite Home Health

  • Home Health Agency
  • Springdale, AR
  • NPI 1043557788
  Care Compare affiliation

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1376373761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11112 SHUMATE CROSSING RD",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727308792",
            "telephone_number": "479-856-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11112 SHUMATE CROSSING RD",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727308792",
            "telephone_number": "479-856-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUES",
        "first_name": "CHARLENE",
        "middle_name": "MAE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "229879",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "229879",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope for Tomorrow Pediatric Foundation
• Priscilla Hope, LCSW
• Sarah Wilson James Bryson, LCSW, LADAC
• John Michael Jameson, PH.D.
• Karen January
• Carrie Jenkins, MMT, MT-BC
• John O Jenkins
• Bobbie Jo Jensen
• John C. Bain, DDS, PA
• Latisha Johnson, LPC

• Nurse Practitioner in Farmington, AR
• Providers in Farmington, AR by specialty
• Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.