Individual provider Active NPI

Jennifer Leann Jay, APRN, FNP-BC

  • Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1477183176
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R096468 Issued in AR
Practice address
1501 S Waldron Rd Ste 200
Fort Smith, AR 72903-2565
Phone
(479) 755-6900
NPI assigned
Jan 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R096468 AR Primary

Addresses

Primary practice location

1501 S Waldron Rd Ste 200
Fort Smith, AR 72903-2565

Mailing address

9009 Balachan Dr
Fort Smith, AR 72908-8601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200409003725 AR Practitioner - Nurse Practitioner 8527497635 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R096468ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ft Smith Rheumatology PC CurrentSince Mar 30, 2020 Accepting new patients

Locations

1501 S Waldron Rd
Ste 202
Fort Smith, AR 72903
Phone (479) 434-2743

Interoperability endpoints

  • Direct secure messaging: jennifer.jay.p1@direct.fsr.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1477183176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9009 BALACHAN DR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729088601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S WALDRON RD STE 200",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032565",
            "telephone_number": "479-755-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAY",
        "first_name": "JENNIFER",
        "middle_name": "LEANN",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "R096468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.