NPIMap

Individual provider Active NPI

Jeff Mathieu Audibert, MD

  • Emergency Medicine Physician
  • Rogers, AR
National Provider Identifier
1407801723
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R-3340 Issued in AR
Practice address
1200 W Walnut St
Rogers, AR 72756-3546
Phone
(479) 636-0200
NPI assigned
May 24, 2006
Last updated
Nov 30, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R-3340 AR Primary

Addresses

Primary practice location

1200 W Walnut St
Rogers, AR 72756-3546

Mailing address

PO Box 634706
Cincinnati, OH 45263-0001

Other identifiers 1

IdentifierTypeStateIssuer
P00208278OtherARRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050428001140 AR Practitioner - Emergency Medicine 9234178252 Reassigns benefits to 5 organizations
I20190212002792 TX Practitioner - Emergency Medicine 9234178252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tufts University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choctaw Nation of OklahomaGroup PAC ID 1759294838, 271 clinicians

Practice addresses (Care Compare)

1 Choctaw Way
Talihina, OK 74571-2022
Phone (539) 316-6391

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-3340ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monticello Ess LLC Emergency Medicine CurrentSince Aug 3, 2018 Accepting new patients
Correct Care, Inc. Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
Arkansas Emergency Staffing Solutions, Inc Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Hospital Care Consultants of Fordyce LLC CurrentSince Apr 20, 2018 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Dec 16, 2018 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Dec 16, 2018 Accepting new patients
Ess of Fordyce LLC Emergency Medicine CurrentSince Apr 20, 2018 Accepting new patients
Dewitt Hospital & Nursing Home, Inc. CurrentSince May 21, 2020 Accepting new patients
Mabelvale Community Emergency Physicians Emergency Medicine Past Accepting new patients
Wilhelmina Emergency Physicians LLC Emergency Medicine Past Accepting new patients
QHG of Springdale Inc Past Accepting new patients
Choctaw Nation of Oklahoma Past Accepting new patients

Locations

451 W Locke St
Ashdown, AR 71822
Phone (870) 265-5351

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

1306 W Collin Raye Dr
De Queen, AR 71832
Phone (870) 584-4111

1641 S Whitehead Dr
Dewitt, AR 72042
Phone (870) 946-2971

201 N Clifton St
Fordyce, AR 71742
Phone (870) 352-6300

1801 Martin Luther King Jr Dr
Helena, AR 72342
Phone (870) 338-5800

2729 S Highway 65 82
Lake Village, AR 71653
Phone (870) 265-5351

311 Morrow St N
Mena, AR 71953
Phone (479) 394-6100

778 Scogin Dr
Monticello, AR 71655
Phone (870) 367-2411

229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

Interoperability endpoints

  • Direct secure messaging: jaudib01@yourcarecommunity.org
  • Direct secure messaging: jaudibert21475@choctawnation.direct-ci.com

Organizations & group practices 12

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.

Hospital & facility affiliations 11

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1407801723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634706",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W WALNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563546",
            "telephone_number": "479-636-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUDIBERT",
        "first_name": "JEFF",
        "middle_name": "MATHIEU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "R-3340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00208278",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.