Individual provider Active NPI

Jenna Thomas

  • Family Nurse Practitioner
  • Plentywood, MT
National Provider Identifier
1740728104
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A134018 Issued in IA
Practice address
440 W Laurel Ave
Plentywood, MT 59254-1526
Phone
(406) 765-4700
NPI assigned
Feb 6, 2017
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A134018 IA Primary
Primary Care Nurse Practitioner 363LP2300X 121966 AR

Addresses

Primary practice location

440 W Laurel Ave
Plentywood, MT 59254-1526

Mailing address

1100 N College Ave
Fayetteville, AR 72703-1944
Phone (794) 443-4301

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
I20191001001630 AR Practitioner - Nurse Practitioner 1850677147 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134018IAMDFamily Nurse Practitioner
121966ARMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care Arkansas, P.a. CurrentSince Aug 20, 2019 Accepting new patients
Medexpress Urgent Care Arkansas, P.a. CurrentSince Aug 20, 2019 Accepting new patients
WH Ar Medical PLLC Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

12300 Chenal Pkwy
Little Rock, AR 72211
Phone (501) 221-8661

12300 Chenal Pkwy
#C
Little Rock, AR 72211
Phone (501) 221-8661

1160 S 40th St
Springdale, AR 72762
Phone (479) 750-2971

423 Fortress Blvd
Morgantown, WV 26508
Phone (844) 852-9510

Organizations & group practices 4

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": "1486339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1740728104",
    "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": "794-443-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 W LAUREL AVE",
            "city": "PLENTYWOOD",
            "state": "MT",
            "postal_code": "592541526",
            "telephone_number": "406-765-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-06",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A134018",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AR",
            "license": "121966",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plentywood, MT

Sources for this page

Verify at the official NPI Registry.