Individual provider Active NPI

Katie N Gage, DNP

  • Family Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1497241343
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A005779 Issued in AR
Practice address
621 E Matthews Ave
Jonesboro, AR 72401
Phone
(870) 932-6799
NPI assigned
Jul 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X A005779 AR Primary

Addresses

Primary practice location

621 E Matthews Ave
Jonesboro, AR 72401

Mailing address

621 E Matthews Ave
Jonesboro, AR 72401-3145
Phone (870) 932-6799

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
I20180817002052 AR Practitioner - Nurse Practitioner 7911256318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Bernards Physician Clinics IncGroup PAC ID 7012311269, 211 clinicians

Practice addresses (Care Compare)

621 E Matthews Ave
Jonesboro, AR 72401-3145
Phone (870) 932-6799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.22 of 100Reported as group
Quality
53.73
Improvement activities
40
Cost
75.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005779ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Physician Clinics, Inc. CurrentSince Jun 1, 2025 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients
NE Arkansas Otolaryngology Facial Surgery P a CurrentSince Jul 23, 2018 Accepting new patients
St Bernards Physician Clinics Inc CurrentSince Jun 1, 2025 Accepting new patients

Locations

1005 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-1242

621 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 932-6799

Interoperability endpoints

  • Direct secure messaging: katie.gage@sbpc.medalliesdirect.net
  • Direct secure messaging: kblalack@sbpc.medalliesdirect.net

Organizations & group practices 4

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 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": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1497241343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013145",
            "telephone_number": "870-932-6799",
            "fax_number": "870-932-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-932-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGE",
        "first_name": "KATIE",
        "middle_name": "N",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.