Individual provider Active NPI

Brittany K Fair, PA

  • Physician Assistant
  • Bay, AR
National Provider Identifier
1891409470
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PT2023-002 Issued in AR
Practice address
201 S Bay Dr
Bay, AR 72411-9482
Phone
(870) 770-1920
NPI assigned
Jan 9, 2023
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PT2023-002 AR Primary

Addresses

Primary practice location

201 S Bay Dr
Bay, AR 72411-9482

Mailing address

4196 Highway 62 412
Hardy, AR 72542-8002

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
I20230310000282 AR Practitioner - Physician Assistant 6002289139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Bernards Physician Clinics IncGroup PAC ID 7012311269, 211 clinicians

Practice addresses (Care Compare)

1005 E Matthews Ave
Jonesboro, AR 72401-4308
Phone (870) 935-1242

1007 E Matthews Ave
Jonesboro, AR 72401-4308
Phone (870) 336-0472

303 E Matthews Ave
Suite 100
Jonesboro, AR 72401-3113
Phone (870) 207-2926

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PT2023-002ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Physician Clinics Inc CurrentSince May 11, 2024 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients
St Bernards Physician Clinics Inc CurrentSince May 11, 2024 Accepting new patients
St. Bernards Urology Associates, Inc. Past Accepting new patients

Locations

1005 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-1242

Interoperability endpoints

  • Direct secure messaging: bkfair1@sbpc.medalliesdirect.net

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1891409470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4196 HIGHWAY 62 412",
            "city": "HARDY",
            "state": "AR",
            "postal_code": "725428002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S BAY DR",
            "city": "BAY",
            "state": "AR",
            "postal_code": "724119482",
            "telephone_number": "870-770-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "BRITTANY",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PT2023-002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay, AR

Sources for this page

Verify at the official NPI Registry.