Individual provider Active NPI

Kaitlyn Nugent

  • Psychiatric/Mental Health Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1750767299
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
A004483 Issued in AR
Practice address
615 E Matthews Ave
Suite a
Jonesboro, AR 72401-3145
Phone
(870) 930-9090
NPI assigned
Aug 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X A004483 AR Primary

Addresses

Primary practice location

615 E Matthews Ave
Suite a
Jonesboro, AR 72401-3145

Mailing address

615 E Matthews Ave
Suite a
Jonesboro, AR 72401-3145

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
I20151029002347 AR Practitioner - Nurse Practitioner 9436469632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Bernards Hospital Inc.Group PAC ID 0941105480, shared by 10 NPIs, 187 clinicians

Practice addresses (Care Compare)

2712 E Johnson Ave
Jonesboro, AR 72405-1874
Phone (870) 972-4100

615 E Matthews Ave
SBBH/Counseling
Jonesboro, AR 72401-3145
Phone (870) 930-9090

Hospital & facility affiliations

  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A004483ARMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Physician Clinics Inc Current Accepting new patients
St Bernards Hospital Inc CurrentSince Nov 1, 2021 Accepting new patients
St. Bernards Hospital, Inc Current Accepting new patients
St Bernards Hospital Inc CurrentSince Aug 25, 2015 Accepting new patients
St Bernards Hospital Inc. CurrentSince Aug 25, 2015 Accepting new patients

Locations

2712 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 268-4107

615 E Matthews Ave
Ste A
Jonesboro, AR 72401
Phone (870) 390-9090

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

2801 Medical Center Dr
Pocahontas, AR 72455
Phone (870) 892-6000

Interoperability endpoints

  • Direct secure messaging: krnugent@sbpc.medalliesdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1750767299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E MATTHEWS AVE",
            "address_2": "SUITE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E MATTHEWS AVE",
            "address_2": "SUITE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013145",
            "telephone_number": "870-930-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUGENT",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "A004483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.