Individual provider Active NPI

Kaitlyn Michelle Jeffcoat, APRN

  • Acute Care Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1891365987
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
216130 Issued in AR
Practice address
5 Saint Vincent Cir Ste 501
Little Rock, AR 72205-5414
Phone
(501) 666-2894
NPI assigned
Jun 30, 2021
Last updated
Jun 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 216130 AR Primary

Addresses

Primary practice location

5 Saint Vincent Cir Ste 501
Little Rock, AR 72205-5414

Mailing address

5 Saint Vincent Cir Ste 501
Little Rock, AR 72205-5414
Phone (501) 666-2894

Other names 1

  • Kaitlyn Michelle Miller 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
I20210720003974 AR Practitioner - Nurse Practitioner 1557764107 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216130ARMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jack Stephens Heart Institute LLC CurrentSince Jul 1, 2021 Accepting new patients
Watkins, Bauer & Meadors, P.a. PastSince Jul 1, 2021 Accepting new patients

Locations

5 Saint Vincent Cir
Ste 501
Little Rock, AR 72205
Phone (501) 666-2894

Organizations & group practices 2

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1891365987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SAINT VINCENT CIR STE 501",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055414",
            "telephone_number": "501-666-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SAINT VINCENT CIR STE 501",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055414",
            "telephone_number": "501-666-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFCOAT",
        "first_name": "KAITLYN",
        "middle_name": "MICHELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "216130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "MILLER",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.