Active NPI
Jaclyn McCardell
- Driver
- Jacksonville, AR
National Provider Identifier
1396466843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 933104234
- Practice address
- 601 S 1St St
Jacksonville, AR 72076-4383 - Phone
- (501) 647-2321
- NPI assigned
- Sep 2, 2022
- Last updated
- Sep 2, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 933104234 | AR | Primary |
Addresses
Primary practice location
601 S 1St St
Jacksonville, AR 72076-4383
Mailing address
14 Dellwood Dr
Little Rock, AR 72209-1612
Phone (501) 366-4256
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | firstclasstransportation2022@gmail.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 933104234 | AR | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662076800000",
"number": "1396466843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 DELLWOOD DR",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722091612",
"telephone_number": "501-366-4256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 S 1ST ST",
"city": "JACKSONVILLE",
"state": "AR",
"postal_code": "720764383",
"telephone_number": "501-647-2321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCARDELL",
"first_name": "JACLYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-02",
"last_updated": "2022-09-02",
"certification_date": "2022-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "AR",
"license": "933104234",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "firstclasstransportation2022@gmail.com",
"affiliation": "N",
"address_1": "601 S 1st St",
"city": "Jacksonville",
"state": "AR",
"country_code": "US",
"postal_code": "720764383",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jacksonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.