Active NPI
Valari Aisha Landrum, APRN
- Family Nurse Practitioner
- Jonesboro, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A003754
- Practice address
- 4802 E Johnson Ave
Jonesboro, AR 72401-8413 - Phone
- (870) 936-8000
- Fax
- (870) 934-3636
- NPI assigned
- Aug 31, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A003754 | AR | Primary |
Addresses
Primary practice location
4802 E Johnson Ave
Jonesboro, AR 72401-8413
Mailing address
PO Box 1960
Jonesboro, AR 72403-1960
Phone (870) 936-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 195411758 | Medicaid | AR |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1111 Windover Rd
Jonesboro, AR 72401-6159
Phone (870) 935-5432
4700 W Kingshighway
Paragould, AR 72450-3465
Phone (870) 240-8402
4800 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000
4802 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000
4808 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000
4901 E Johnson Ave
Jonesboro, AR 72405-8417
Phone (870) 932-8222
527 N 6TH St
Blytheville, AR 72315-2407
Phone (870) 936-8000
Merit-based Incentive Payment System (MIPS)
- Final score
- 75.65 of 100
- Quality
- 44.87
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A003754 | AR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Current | Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Current | Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Current | Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Past | Accepting new patients |
Locations
4802 E Johnson Ave
Jonesboro, AR 72405
Phone (901) 227-9820
1111 Windover Rd
Jonesboro, AR 72401
Phone (870) 935-5432
4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Jonesboro, AR
- NPI 1861721839
-
- Mobile Mammography Clinic/Center
- Jonesboro, AR
- NPI 1417721689
-
- Clinical Medical Laboratory
- Jonesboro, AR
- NPI 1801127030
-
- Anesthesiology Physician
- Jonesboro, AR
- NPI 1992036032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465776000000",
"number": "1811246127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1960",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724031960",
"telephone_number": "870-936-8000",
"fax_number": "870-934-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4802 E JOHNSON AVE",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724018413",
"telephone_number": "870-936-8000",
"fax_number": "870-934-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDRUM",
"first_name": "VALARI",
"middle_name": "AISHA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-31",
"last_updated": "2016-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A003754",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "195411758",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.