Individual provider Active NPI

Jacquelyn Renee Isaacs

  • Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1487295572
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
122198 Issued in AR
Practice address
1000 S Waldron Rd
Fort Smith, AR 72903-2550
Phone
(479) 221-9922
Fax
(479) 221-9988
NPI assigned
Oct 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 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 122198 AR Primary

Addresses

Primary practice location

1000 S Waldron Rd
Fort Smith, AR 72903-2550

Mailing address

1000 S Waldron Rd
Fort Smith, AR 72903-2550
Phone (479) 221-9922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200114001490 AR Practitioner - Nurse Practitioner 1355776618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, 361 clinicians

Practice addresses (Care Compare)

1000 S Waldron Rd
Fort Smith, AR 72903-2550
Phone (479) 221-9922

Hospital & facility affiliations

  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Jan 12, 2020 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Jan 12, 2020 Accepting new patients

Locations

1000 S Waldron Rd
Fort Smith, AR 72903
Phone (479) 221-9922

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1487295572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S WALDRON RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032550",
            "telephone_number": "479-221-9922",
            "fax_number": "479-221-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S WALDRON RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032550",
            "telephone_number": "479-221-9922",
            "fax_number": "479-221-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAACS",
        "first_name": "JACQUELYN",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "122198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.