Jackie Suzanne Day, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3995-C Issued in AR

Practice address

1101 Jackson St SW
Gravette, AR 72736-9121

Phone

(479) 787-5221

Fax

(479) 787-5613

NPI assigned

Sep 28, 2009

Last updated

Aug 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Jackie Suzanne Keisker Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sgoh Acquisition Inc

  dba Ozarks Community Hospital of Gravette

  • Critical Access Hospital
  • Gravette, AR
  • NPI 1568643005
  Medicare reassignment NPD
• Sgoh Acquisition Inc

  dba Och Decatur Clinic

  • Rural Health Clinic/Center
  • Decatur, AR
  • NPI 1699513507
  NPD

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1720312416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 JACKSON ST SW",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369121",
            "telephone_number": "479-787-5221",
            "fax_number": "479-787-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 JACKSON ST SW",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369121",
            "telephone_number": "479-787-5221",
            "fax_number": "479-787-5613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 SE 3rd St",
            "address_purpose": "LOCATION",
            "city": "Bryant",
            "state": "AR",
            "postal_code": "720224033",
            "country_code": "US",
            "telephone_number": "501-416-2017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAY",
        "first_name": "JACKIE",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "3995-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "KEISKER",
            "middle_name": "SUZANNE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joy Ann Coonfield, LM, CPM
• Daniel Hunt Cooper, MD
• Anna Mae Cowgur, CRNA
• Drake Hunter Cullum, MD
• Frederick Nicholas Day III, DPM
• Designed for Life Counseling & Consulting Services, PLLC
• Rayetta Eaton, MD
• Samantha Jean Eaton
• Arthur F Evans, DDS
• Kayla Lorraine Flowers, LCSW

• Clinical Social Worker in Gravette, AR
• Providers in Gravette, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.