Individual provider Active NPI

Jamie Hale, APRN

  • Adult Health Nurse Practitioner
  • Mountain Home, AR
National Provider Identifier
1710462056
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A005926 Issued in AR
Practice address
130 E 9TH St
Mountain Home, AR 72653-4704
Phone
(870) 425-6398
Fax
(870) 425-6402
NPI assigned
Oct 2, 2018
Last updated
Feb 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A005926 AR Primary

Addresses

Primary practice location

130 E 9TH St
Mountain Home, AR 72653-4704

Mailing address

130 E 9TH St
Mountain Home, AR 72653-4704
Phone (870) 425-6398

Other identifiers 2

IdentifierTypeStateIssuer
A005926OtherARCNP LICENSE
R102783OtherARRN LICENSE

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
I20220406001742 AR Practitioner - Nurse Practitioner 0648666370 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Newman, M.D. Plastic Surgery, P.a. CurrentSince Jan 1, 2022 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

130 E 9th St
Mountain Home, AR 72653
Phone (870) 425-6398

200 N College St
Mountain Home, AR 72653
Phone (870) 424-4550

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1710462056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E 9TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726534704",
            "telephone_number": "870-425-6398",
            "fax_number": "870-425-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E 9TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726534704",
            "telephone_number": "870-425-6398",
            "fax_number": "870-425-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "JAMIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "A005926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNP LICENSE",
            "identifier": "A005926",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "R102783",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

Verify at the official NPI Registry.