Jodi Marie Gibson, ANP
Individual provider Active NPI Nurse Practitioner · Yellville, AR
NPI 1528296878 · NPPES record last updated Aug 13, 2026
Key facts
- NPI
- 1528296878
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- ATP 000216 (AR)
- Practice address
- 319 Highway 14 S
Yellville, AR 72687-8597 - Phone
- (870) 449-7000
- NPI assigned
- Jun 25, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fast Pace Mississippi PLLC
Practice addresses (Care Compare)
1020 Hwy 62 E
Mountain Home, AR 72653-3216
Phone (870) 337-2172
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091006000439 | AR | Practitioner - Nurse Practitioner | 0840336897 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ATP 000216 | AR | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Mississippi, PLLC | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Nurse Practitioner | Current |
Accepting new patients |
| Fast Pace Mississippi, PLLC | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
1020 Highway 62 E
Mountain Home, AR 72653
Phone (870) 337-2171
200 S 20th St
Ste B
Rogers, AR 72758
Phone (479) 636-9393
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ATP 000216 | AR | Yes |
Addresses
Primary practice location
319 Highway 14 S
Yellville, AR 72687-8597
Mailing address
2263 Highway 65 N
Marshall, AR 72650-7660
Phone (870) 448-5733
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5V274 | Other | AR | MEDICARE PTAN |
| 179823758 | Medicaid | AR |
Other providers in Yellville, AR
- Allison Dougan-Molpus
- Duffy Chiropractic Inc
- Korbin Riley Duffy
- Henry Esperon
- Molly Fila
- John Green III
- Sheila Groblebe
- Harps Food Stores Inc
- Health Resources of Arkansas
- John Michael Hilvert
All providers in Yellville, AR · Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.