Individual provider Active NPI

Jessica Musgrove

  • Psychiatric/Mental Health Nurse Practitioner
  • Fayetteville, AR
National Provider Identifier
1760965008
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
A005860 Issued in AR
Practice address
2580 E Joyce Blvd Ste 1
Fayetteville, AR 72703-3924
Phone
(479) 305-7201
Fax
(479) 900-9930
NPI assigned
Sep 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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 A005860 AR Primary

Addresses

Primary practice location

2580 E Joyce Blvd Ste 1
Fayetteville, AR 72703-3924

Mailing address

2580 E Joyce Blvd Ste 1
Fayetteville, AR 72703-3924
Phone (479) 305-7201

Other practice location 1

4253 N Crossover Rd
Fayetteville, AR 72703-4593
Phone (479) 442-8577

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
I20190514000077 AR Practitioner - Nurse Practitioner 5193068237 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texarkana Behavioral Associates LCGroup PAC ID 9436062379, 12 clinicians

Practice addresses (Care Compare)

4253 N Crossover Rd
Fayetteville, AR 72703-4593
Phone (479) 521-5731

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Arkansas Community Mental Health Center Inc CurrentSince Sep 1, 2020 Accepting new patients
Texarkana Behavioral Associates, L.C. CurrentSince Apr 5, 2019 Accepting new patients
Texarkana Behavioral Associates LC CurrentSince Apr 5, 2019 Accepting new patients
Northeast Arkansas Community Mental Health Center Inc CurrentSince Sep 1, 2020 Accepting new patients
Dauntless Psychiatry CurrentSince Oct 31, 2021 Accepting new patients
Texarkana Behavioral Associates, L.C. Current Accepting new patients
Northeast Arkansas Community Mental Health Center Inc Current Accepting new patients

Locations

815 Fort St
Ste A
Barling, AR 72923
Phone (479) 494-5740

2580 E Joyce Blvd
Ste 1
Fayetteville, AR 72703
Phone (479) 305-7201

4253 N Crossover Rd
Fayetteville, AR 72703
Phone (479) 443-6496

2707 Browns Ln
Jonesboro, AR 72401
Phone (870) 972-4000

2400 S 48th St
Springdale, AR 72762
Phone (479) 725-5115

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1760965008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 E JOYCE BLVD STE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033924",
            "telephone_number": "479-305-7201",
            "fax_number": "479-900-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 E JOYCE BLVD STE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033924",
            "telephone_number": "479-305-7201",
            "fax_number": "479-900-9930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4253 N Crossover Rd",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727034593",
            "country_code": "US",
            "telephone_number": "479-442-8577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSGROVE",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "A005860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.