Individual provider Active NPI

Jordan L McIntire, APRN

  • Family Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1649780404
Registry record updated Oct 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F08170356 Issued in AR
Practice address
225 E Jackson Ave
Jonesboro, AR 72401-3119
Phone
(870) 207-5200
Fax
(870) 207-6510
NPI assigned
Oct 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F08170356 AR Primary

Addresses

Primary practice location

225 E Jackson Ave
Jonesboro, AR 72401-3119

Mailing address

225 E Jackson Ave
Jonesboro, AR 72401-3119

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
I20180129000829 AR Practitioner - Nurse Practitioner 1658631395 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cancer Care Associates IncGroup PAC ID 2769637222, 23 clinicians
St Bernards Hospital Inc.Group PAC ID 0941105480, 187 clinicians

Practice addresses (Care Compare)

225 E Jackson Ave
Jonesboro, AR 72401-3119
Phone (870) 207-8210

225 E Washington Ave
St Bernards Medical Center
Jonesboro, AR 72401-3119
Phone (870) 972-4100

Hospital & facility affiliations

  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F08170356ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Health Group, Inc CurrentSince Nov 15, 2018 Accepting new patients
Cancer Care Associates Inc CurrentSince Dec 1, 2021 Accepting new patients
St Bernards Hospital Inc. CurrentSince Jan 4, 2018 Accepting new patients

Locations

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

4000 Linwood Dr
Ste A
Paragould, AR 72450
Phone (870) 239-8503

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1649780404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E JACKSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E JACKSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013119",
            "telephone_number": "870-207-5200",
            "fax_number": "870-207-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTIRE",
        "first_name": "JORDAN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "F08170356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.