Individual provider Active NPI

Jessica Jean Newcomb, APRN

  • Pediatric Nurse Practitioner
  • Johnson, AR
National Provider Identifier
1881150563
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
A006137 Issued in AR
Practice address
4301 Greathouse Springs Road
Johnson, AR 72741
Phone
(479) 684-3000
NPI assigned
Feb 18, 2019
Last updated
Feb 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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 A006137 AR Primary

Addresses

Primary practice location

4301 Greathouse Springs Road
Johnson, AR 72741

Mailing address

4052 N Abington CT
Fayetteville, AR 72703-5047
Phone (479) 856-2601

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
I20190321001740 AR Practitioner - Nurse Practitioner 6709126196 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A006137ARMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Physicians LLC CurrentSince Mar 1, 2019 Accepting new patients
Northwest Physicians LLC CurrentSince Mar 1, 2019 Accepting new patients
Northwest Benton County Physician Services LLC CurrentSince Mar 1, 2019 Accepting new patients
Saveritt Pediatrics PLLC Past Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

101 Sun Meadow Dr
Centerton, AR 72719
Phone (479) 273-1426

5203 Willow Creek Dr
Ste 2
Springdale, AR 72762
Phone (479) 365-2355

601 W Maple Ave
Ste 403
Springdale, AR 72764
Phone (479) 750-2742

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": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1881150563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4052 N ABINGTON CT",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035047",
            "telephone_number": "479-856-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 GREATHOUSE SPRINGS ROAD",
            "city": "JOHNSON",
            "state": "AR",
            "postal_code": "72741",
            "telephone_number": "479-684-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMB",
        "first_name": "JESSICA",
        "middle_name": "JEAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-18",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AR",
            "license": "A006137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson, AR

Sources for this page

Verify at the official NPI Registry.