Individual provider Active NPI

Kelly Michele McCain, APRN

  • Acute Care Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1750899266
Registry record updated Jan 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
A005445 Issued in AR
Practice address
201 E Oak Ave
Jonesboro, AR 72401-4163
Phone
(870) 935-6729
Fax
(870) 268-4410
NPI assigned
Jan 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A005445 AR
Acute Care Nurse Practitioner 363LA2100X A005445 AR Primary

Addresses

Primary practice location

201 E Oak Ave
Jonesboro, AR 72401-4163

Mailing address

201 E Oak Ave
Jonesboro, AR 72401-4163
Phone (870) 935-6729

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
I20191031002860 AR Practitioner - Nurse Practitioner 9032441654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Bernards Hospital Inc.Group PAC ID 0941105480, 187 clinicians

Practice addresses (Care Compare)

225 E Washington Ave
St Bernards Medical Center
Jonesboro, AR 72401-3119
Phone (870) 972-4100

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005445ARMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Hospital Inc. CurrentSince Jun 19, 2023 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

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

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

201 E Oak Ave
Jonesboro, AR 72401

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 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": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1750899266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E OAK AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014163",
            "telephone_number": "870-935-6729",
            "fax_number": "870-268-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E OAK AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014163",
            "telephone_number": "870-935-6729",
            "fax_number": "870-268-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAIN",
        "first_name": "KELLY",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "A005445",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A005445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.