Deborah Carol Fairchild, RNP
Individual provider Active NPI Clinical Nurse Specialist · Jonesboro, AR
NPI 1851315352 · NPPES record last updated Jan 14, 2016
Key facts
- NPI
- 1851315352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Nurse Specialist 364S00000X
- License
- S01062 (AR)
- Practice address
- 4802 E Johnson Ave
Jonesboro, AR 72401-8413 - Phone
- (870) 936-8000
- Fax
- (870) 934-3628
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northeast Arkansas Clinic Charitable Foundation, Inc.
Practice addresses (Care Compare)
1111 Windover Rd
Jonesboro, AR 72401-6159
Phone (870) 935-5432
3001 Apache Dr
Suite B
Jonesboro, AR 72401-7447
Phone (870) 936-8000
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
Merit-based Incentive Payment System (MIPS)
- Final score
- 75.65 of 100
- Quality
- 44.87
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.98
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100331001137 | AR | Practitioner - Nurse Practitioner | 3971639600 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P00657 | AR | MD | Nurse Practitioner |
| S01062 | AR | MD | Clinical Nurse Specialist |
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 | |
| Northeast Arkansas Clinic, PA | 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
311 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-4150
4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100
Interoperability endpoints
- dfairchild29405@direct.bmhcc.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | P00657 | AR | |
| Clinical Nurse Specialist | 364S00000X | S01062 | AR | Yes |
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 providers in Jonesboro, AR
- Eyemart Express LTD
- Jose Andres Fabre Quinones
- Jamie F. Fain
- Kaylynn S Fain
- Mandi Lyn Fair
- Christopher M Fallon
- Families, Inc of Arkansas
- Family Physicians of Jonesboro
- Jennifer R Farber
- Asher Faries
All providers in Jonesboro, AR · Clinical Nurse Specialist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.