Individual provider Active NPI

Jennifer Becker

  • Pediatric Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1861868648
Registry record updated Apr 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
A004528 Issued in AR
Practice address
1301 S E St
Fort Smith, AR 72901-4716
Phone
(479) 785-2431
Fax
(479) 494-7787
NPI assigned
Aug 17, 2015
Last updated
Apr 14, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X A004528 AR Primary

Addresses

Primary practice location

1301 S E St
Fort Smith, AR 72901-4716

Mailing address

612 S 12TH St
Fort Smith, AR 72901-4702
Phone (479) 785-2431

Other identifiers 2

IdentifierTypeStateIssuer
211247758MedicaidAR
200605840AMedicaidOK

Other names 1

  • Jennifer Elizabeth Scheurer Former name

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
I20151112000845 AR Practitioner - Nurse Practitioner 9133439664 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A004528ARMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Sep 6, 2015 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Sep 6, 2015 Accepting new patients
Premier Pediatrics PLLC Past Accepting new patients
University of Arkansas for Medical Sciences Past Accepting new patients

Locations

1301 S E St
Fort Smith, AR 72901
Phone (479) 785-2431

612 S 12th St
Fort Smith, AR 72901
Phone (479) 785-2431

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1861868648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S 12TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014702",
            "telephone_number": "479-785-2431",
            "fax_number": "479-494-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S E ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014716",
            "telephone_number": "479-785-2431",
            "fax_number": "479-494-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AR",
            "license": "A004528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211247758",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200605840A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SCHEURER",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.