Matthew Bradley Jennings, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E-9048 Issued in AR

Practice address

1100 N College Ave
Fayetteville, AR 72703-1944

Phone

(479) 443-4301

Fax

(479) 587-5915

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• South Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • El Dorado, AR
  • NPI 1942435458
  Medicare reassignment NPD
• South Arkansas Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Siloam Springs, AR
  • NPI 1225452055
  NPD
• South Arkansas Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Bentonville, AR
  • NPI 1447671490
  NPD

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1740271014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301",
            "fax_number": "479-587-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301",
            "fax_number": "479-587-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "MATTHEW",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-9048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS#",
            "identifier": "04515143",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth Nichols Jeffries, OTR/L
• Smith Steven Jenkins, PHARMD
• Dayna Jennings-Hughes, MD
• Brandon R Jennings
• Farrah A Jennings, PA-C
• Steven Jennings, LCSW
• Nathan Charles Jensen, LAC
• Jesse R Gray DDS PA
• Christina Jibke-Seese
• Jillian Dudley

• Family Medicine Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.