Jacob Micah Boydstun, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

E-9954 Issued in AR

Practice address

4301 W Markham St
Little Rock, AR 72205-7101

Phone

(432) 770-5923

NPI assigned

Apr 11, 2013

Last updated

Mar 19, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of North Texas HSC, College of Osteopathic Med, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pure Balance of Nwa PLLCGroup PAC ID 6901344928, 8 clinicians

Texarkana Behavioral Associates LCGroup PAC ID 9436062379, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Pure Balance of Nwa PLLC

  • Psychiatry Physician
  • Rogers, AR
  • NPI 1073359931
  Medicare reassignment Care Compare group NPD Authorized official
• Texarkana Behavioral Associates, L.C.

  dba Valley Behavioral Health System Outpatient Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Barling, AR
  • NPI 1467483677
  Medicare reassignment Care Compare group NPD
• Chenal Family Therapy, PLC

  • Mental Health Counselor
  • Little Rock, AR
  • NPI 1356604219
  Medicare reassignment NPD
• Uhs of Springwoods LLC

  dba Springwoods Behavioral Health Services

  • Psychiatric Hospital
  • Fayetteville, AR
  • NPI 1790925972
  Medicare reassignment NPD
• Texarkana Behavioral Associates, L.C.

  dba Vantage Point of Northwest Arkansas

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fayetteville, AR
  • NPI 1194758953
  NPD
• Texarkana Behavioral Associates, L.C.

  dba Vantage Point of Northwest Arkansas

  • Psychiatric Hospital
  • Fayetteville, AR
  • NPI 1639137565
  NPD
• Transitions Counseling Clinic PLC

  • Professional Counselor
  • De Queen, AR
  • NPI 1902501281
  NPD (past)

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1568805299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "432-770-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "432-770-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYDSTUN",
        "first_name": "JACOB",
        "middle_name": "MICAH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "E-9954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franklin August Boyd, MD
• Jennifer Lynn Boyd, APRN
• Kharisma Boyd
• Rachael Nicole Boyd
• Robert Samuel Boyd, PH.D.
• Gwyneth Boyer
• Maranda Boyer, CRNA
• Rema Lynn Boyer, LPN
• Boyette Facial Plastic Surgery, PA
• Jennings R Boyette, MD

• Psychiatry Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Psychiatry Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.