Kaitlyn Michelle Jeffcoat, APRN

Key facts

NPI

1891365987

Entity type

Individual (NPI type 1)

Primary specialty

Acute Care Nurse Practitioner 363LA2100X

License

216130 (AR)

Practice address

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

Phone

(501) 666-2894

NPI assigned

Jun 30, 2021

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Jack Stephens Heart Institute LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Little Rock, AR · NPI 1033404199
  Medicare reassignment NPD AR
• Watkins, Bauer & Meadors, P.a. Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Little Rock, AR · NPI 1811073604
  NPD (past)

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

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

Practice roles

Locations

Specialties & licenses

Addresses

Other names

• Kaitlyn Michelle Miller Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 30, 2021.

{
    "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"
        }
    ]
}

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All providers in Little Rock, AR · Acute Care Nurse Practitioner in Arkansas