Individual provider Active NPI

Jennifer R Tubbs

  • Clinical Social Worker
  • Jonesboro, AR
National Provider Identifier
1669787990
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6882-C Issued in AR
Practice address
300 Carson St
Jonesboro, AR 72401
Phone
(870) 930-9090
NPI assigned
Aug 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 6882-C AR Primary

Addresses

Primary practice location

300 Carson St
Jonesboro, AR 72401

Mailing address

300 Carson St
Jonesboro, AR 72401-3104
Phone (870) 930-9090

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160106001039 AR Practitioner - Clinical Social Worker 2365744430 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Bernards Hospital Inc.Group PAC ID 0941105480, 187 clinicians

Practice addresses (Care Compare)

2712 E Johnson Ave
Jonesboro, AR 72405-1874
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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Arkansas Community Mental Health Center Inc Current Accepting new patients
Northeast Arkansas Community Mental Health Center CurrentSince Nov 17, 2015 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients
St Bernards Hospital Inc CurrentSince Sep 5, 2018 Accepting new patients
St. Bernards Hospital, Inc Current Accepting new patients
St Bernards Hospital Inc. CurrentSince Sep 5, 2018 Accepting new patients
Northeast Arkansas Community Mental Health Center Inc CurrentSince Nov 17, 2015 Accepting new patients

Locations

2712 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 268-4107

2707 Browns Ln
Jonesboro, AR 72401
Phone (870) 972-4000

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

Interoperability endpoints

  • Direct secure messaging: jrtubbs@sbpc.medalliesdirect.net

Organizations & group practices 7

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": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1669787990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CARSON ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013104",
            "telephone_number": "870-930-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CARSON ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-930-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBBS",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6882-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.