Chrissy Jackson, QBHP

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2005 W Elm St
Rogers, AR 72758-4018

Phone

(479) 636-0083

Fax

(479) 636-0144

NPI assigned

Apr 26, 2011

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

Other identifiers 1

Other names 1

• Chrissy Carson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1386935260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 W BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658073952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 W ELM ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727584018",
            "telephone_number": "479-636-0083",
            "fax_number": "479-636-0144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4171 N Crossover Rd",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727034591",
            "country_code": "US",
            "telephone_number": "479-521-1532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISSY",
        "credential": "QBHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231304795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISSY",
            "last_name": "CARSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kara Iribarren, DPT
• Randall Ray Ironside, PT
• James P Irwin, DO
• Stephen Alexander Irwin, M.D.
• Gary Ivey, PD
• Luke W Jackson, LPC
• Mynhan Huynh Jackson, MD
• Natalie Ann Jackson
• Sandra Dee Jackson
• Svetlana Jackson, LAC

• Case Manager/Care Coordinator in Rogers, AR
• Providers in Rogers, AR by specialty
• Case Manager/Care Coordinator in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.