Jenna Christen Campbell, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

A003780 Issued in AR

Practice address

1312 W Collin Raye Dr
De Queen, AR 71832-2135

Phone

(870) 584-7115

Fax

(870) 642-3388

NPI assigned

Nov 6, 2012

Last updated

Aug 3, 2015By the provider in NPPES

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Western Arkansas Counseling and Guidance Center, IncGroup PAC ID 1355326174, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GFIEAD

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.

• Western Arkansas Counseling & Guidance Center, Inc

  dba The Guidance Center

  • Community/Behavioral Health Agency
  • Fort Smith, AR
  • NPI 1326040692
  Medicare reassignment Care Compare group NPD
• Southwest Arkansas Counseling and Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Texarkana, AR
  • NPI 1598761553
  Medicare reassignment NPD
• Thriveworks Telepsychiatry - Arkansas

  • Mental Health Counselor
  • Fayetteville, AR
  • NPI 1669130928
  Medicare reassignment NPD
• The Guidance Center - Ozark Clinic

  • Community/Behavioral Health Agency
  • Ozark, AR
  • NPI 1144495235
  NPD
• Ouachita Family Practice LLC

  • Family Nurse Practitioner
  • Mena, AR
  • NPI 1225289978
  NPD (past)
• Southwest Arkansas Counseling and Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • De Queen, AR
  • NPI 1194975102
  NPD (past)

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1790039162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 ARKANSAS BLVD",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718542536",
            "telephone_number": "870-773-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 W COLLIN RAYE DR",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718322135",
            "telephone_number": "870-584-7115",
            "fax_number": "870-642-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JENNA",
        "middle_name": "CHRISTEN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "A003780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A003780",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Italia Bustamante-Quintana, LMSW
• Alan Byrd
• C Wallace Liles III O D LLC
• C Wallace Liles Jr OD PA (Liles Vision Clinic)
• Ashley Caldwell, MS, CCC-SLP
• Megan Elaine Carter
• Laken Cassady, RN
• Cassandra Castaneda, LAC
• Aline Catamin
• Jessica Jo Chalk

• Psychiatric/Mental Health Nurse Practitioner in De Queen, AR
• Providers in De Queen, AR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.