Individual provider Active NPI

Jessica Wynne Woodard, CNS

  • Adult Health Clinical Nurse Specialist
  • Mountain Home, AR
National Provider Identifier
1679908545
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
S002279 Issued in AR
Practice address
624 Hospital Dr
Mountain Home, AR 72653-2955
Phone
(870) 508-1000
Fax
(870) 424-6616
NPI assigned
Sep 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X S002279 AR Primary

Addresses

Primary practice location

624 Hospital Dr
Mountain Home, AR 72653-2955

Mailing address

PO Box 1269
Mountain Home, AR 72654-1269
Phone (870) 424-7070

Other identifiers 1

IdentifierTypeStateIssuer
210475758MedicaidAR

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
I20150912000217 AR Practitioner - Certified Clinical Nurse Specialist (CNS) 1759698442 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First in Service Hospitalists PAGroup PAC ID 6608825682, 14 clinicians

Practice addresses (Care Compare)

624 Hospital Dr
Mountain Home, AR 72653-2955
Phone (870) 508-1000

Hospital & facility affiliations

  • Baxter Health Hospital, Mountain Home, AR, CCN 040027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Baxter County Regional Hospital Inc CurrentSince Mar 19, 2024 Accepting new patients
First in Service Hospitalists, PA CurrentSince Jul 1, 2015 Accepting new patients
Baxter County Regional Hospital, Inc CurrentSince Mar 19, 2024 Accepting new patients

Locations

624 Hospital Dr
Mountain Home, AR 72653
Phone (870) 424-1000

860 Highway 62 E
Ste 9
Mountain Home, AR 72653
Phone (870) 424-3181

860 Highway 62 E
Ste 10
Mountain Home, AR 72653
Phone (870) 424-2224

624 Hospital Dr
#3600
Mountain Home, AR 72653

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 2

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": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1679908545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1269",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726541269",
            "telephone_number": "870-424-7070",
            "fax_number": "870-424-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 HOSPITAL DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532955",
            "telephone_number": "870-508-1000",
            "fax_number": "870-424-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "JESSICA",
        "middle_name": "WYNNE",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "AR",
            "license": "S002279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210475758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

Verify at the official NPI Registry.