NPIMap

Individual provider Active NPI

Jennie Marie Spears, FNP-C

  • Nurse Practitioner
  • Eureka Springs, AR
National Provider Identifier
1699785899
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A005272 Issued in AR
Practice address
146A Passion Play Rd
Eureka Springs, AR 72632
Phone
(479) 253-9746
Fax
(479) 253-2464
NPI assigned
Aug 9, 2006
Last updated
Jun 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP4579 AZ
Nurse Practitioner 363L00000X A005272 AR Primary

Addresses

Primary practice location

146A Passion Play Rd
Eureka Springs, AR 72632

Mailing address

PO Box 550
Lowell, AR 72745-0550
Phone (479) 463-7775

Other identifiers 1

IdentifierTypeStateIssuer
748699MedicaidAZ

Other names 1

  • Jennie Marie Elliott Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170728000770 AR Practitioner - Nurse Practitioner 7315040011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John House Properties, Inc.Group PAC ID 3072909969, 3 clinicians

Practice addresses (Care Compare)

105 Passion Play Rd
Suite C
Eureka Springs, AR 72632-9342
Phone (479) 927-1100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A005272ARMDNurse Practitioner
AP4579AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System CurrentSince Jul 1, 2017 Accepting new patients
Washington Regional Medical System CurrentSince Jul 1, 2017 Accepting new patients
John House Properties, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Washington Regional Medical Center Past Accepting new patients
Washington Regional Medical System Past Accepting new patients
Physicians Group Services PA Past Accepting new patients
Physicians Group Services PA Nurse Practitioner Past Accepting new patients

Locations

105 Passion Play Rd
Ste C
Eureka Springs, AR 72632
Phone (479) 253-5728

146 Passion Play Rd
Ste A
Eureka Springs, AR 72632
Phone (479) 253-2463

Interoperability endpoints

  • Direct secure messaging: jennie.spears.1@25443.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1699785899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450550",
            "telephone_number": "479-463-7775",
            "fax_number": "479-463-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146A PASSION PLAY RD",
            "city": "EUREKA SPRINGS",
            "state": "AR",
            "postal_code": "72632",
            "telephone_number": "479-253-9746",
            "fax_number": "479-253-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEARS",
        "first_name": "JENNIE",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP4579",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A005272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "748699",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIE",
            "last_name": "ELLIOTT",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eureka Springs, AR

Sources for this page

Verify at the official NPI Registry.