Jasmine Simone McKissick, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E-17905 Issued in AR

Practice address

535 Jordan Dr
Monticello, AR 71655-5714

Phone

(870) 367-6246

NPI assigned

Mar 22, 2021

Last updated

Mar 26, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, AR2 enrollments

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 2

Specialty

Family Practice

Education

University of Arkansas College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ut Medical Group IncGroup PAC ID 3173435369, 98 clinicians

Mainline Health Systems IncGroup PAC ID 5193785590, 55 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.15 of 100Reported as group

Quality

59.97

Promoting interoperability

100

Improvement activities

40

Cost

80.93

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Mainline Health Systems, Inc

  dba Mills Middle School

  • Federally Qualified Health Center (FQHC)
  • Little Rock, AR
  • NPI 1164264834
  Medicare reassignment Care Compare group NPD
• Ut Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Memphis, TN
  • NPI 1780676650

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Mainline Health Systems, Inc

  • Specialist
  • Portland, AR
  • NPI 1407650179
  NPD
• Mainline Health Systems, Inc

  dba Mainline Health Magnolia Clinic

  • Federally Qualified Health Center (FQHC)
  • Magnolia, AR
  • NPI 1972464337
  NPD
• Ut Medical Group, Inc.

  • Ophthalmology Physician
  • Memphis, TN
  • NPI 1326919200
  NPD
• Mainline Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Monticello, AR
  • NPI 1669401501
  NPD (past)

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1619553393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 HIGHWAY 425 S",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554612",
            "telephone_number": "870-942-3000",
            "fax_number": "870-942-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 JORDAN DR",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716555714",
            "telephone_number": "870-367-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "JASMINE",
        "middle_name": "SIMONE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-17905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dyneia McKee
• Matthew Tyler McKeown, DPT
• McKiever Clinic
• McKiever Pharmacy
• Samantha McKinney
• Shellathia L McPherson
• Lorra Ann McQuay, AT
• Ashlen Nicole McRae, OTD, OTR/L
• Meaningful Movement LLC
• Toma Gale Menotti, PHARMD

• Family Medicine Physician in Monticello, AR
• Providers in Monticello, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.