Individual provider Active NPI

Jazzmon Nicole Trice, APRN

  • Adult Health Nurse Practitioner
  • Wrightsville, AR
National Provider Identifier
1548802309
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
122314 Issued in AR
Practice address
8400 Highway 386 East
Wrightsville, AR 72183
Phone
(501) 897-2982
Fax
(501) 897-9898
NPI assigned
Oct 14, 2019
Last updated
Oct 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 122314 AR Primary
Gerontology Nurse Practitioner 363LG0600X 122314 AR

Addresses

Primary practice location

8400 Highway 386 East
Wrightsville, AR 72183

Mailing address

8025 Shadow Valley CV
Alexander, AR 72002-1861
Phone (501) 607-3370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
122314ARMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1548802309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 SHADOW VALLEY CV",
            "city": "ALEXANDER",
            "state": "AR",
            "postal_code": "720021861",
            "telephone_number": "501-607-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 HIGHWAY 386 EAST",
            "city": "WRIGHTSVILLE",
            "state": "AR",
            "postal_code": "72183",
            "telephone_number": "501-897-2982",
            "fax_number": "501-897-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRICE",
        "first_name": "JAZZMON",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "122314",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "122314",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.