NPIMap

Individual provider Active NPI

Jessica Short Chism, MD

  • Rheumatology Physician
  • Fayetteville, AR
National Provider Identifier
1386868545
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
E-5421 Issued in AR
Practice address
3276 N Northhills Blvd
Fayetteville, AR 72703-4005
Phone
(479) 404-2300
Fax
(479) 404-2301
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X E-5421 AR Primary

Addresses

Primary practice location

3276 N Northhills Blvd
Fayetteville, AR 72703-4005

Mailing address

PO Box 550
Lowell, AR 72745-0550
Phone (479) 463-7775

Other identifiers 1

IdentifierTypeStateIssuer
440106901MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110727000696 AR Practitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - Rheumatology 8123296688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine, Rheumatology
Education
University of Arkansas College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Regional Medical System 238 clinicians

Practice addresses (Care Compare)

3276 N N Hills Blvd
Washington Regional Rheumatology
Fayetteville, AR 72703-4005
Phone (479) 463-3070

Hospital & facility affiliations

  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004
  • Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055
  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System Rheumatology CurrentSince Jul 15, 2011 Accepting new patients
Washington Regional Medical System CurrentSince Jul 15, 2011 Accepting new patients
Washington Regional Medical System Past Accepting new patients
Washington Regional Medical System Past Accepting new patients
Washington Regional Medical System Past Accepting new patients
Washington Regional Medical System Past Accepting new patients

Locations

3276 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 442-7030

Interoperability endpoints

  • Direct secure messaging: jessicashort@wrms.allscriptsdirect.net
  • Direct secure messaging: jchism26585@washingtonregional.direct-ci.com

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1386868545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450550",
            "telephone_number": "479-463-7775",
            "fax_number": "479-463-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3276 N NORTHHILLS BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034005",
            "telephone_number": "479-404-2300",
            "fax_number": "479-404-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISM",
        "first_name": "JESSICA",
        "middle_name": "SHORT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AR",
            "license": "E-5421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "440106901",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.