Individual provider Active NPI

Jenny Marie Allen Pratt

  • Certified Registered Nurse Anesthetist
  • Springdale, AR
National Provider Identifier
1912937103
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C002615 Issued in AR
Practice address
2601 Gene George Blvd
Springdale, AR 72762-0845
Phone
(479) 725-6800
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2930 SC
Certified Registered Nurse Anesthetist 367500000X C002615 AR Primary

Addresses

Primary practice location

2601 Gene George Blvd
Springdale, AR 72762-0845

Mailing address

PO Box 251418
Little Rock, AR 72225-1418
Phone (501) 364-1100

Other practice location 1

palmetto health
1321 lady street
columbia, SC 29201
Phone (803) 296-2548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070403000229 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456355254 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2930SCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Jun 28, 2021 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jun 28, 2021 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Arkansas Children'S Hospital CurrentSince Jun 28, 2021 Accepting new patients
Arkansas Childrens Hospital CurrentSince Jun 28, 2021 Accepting new patients
Anesthesia Services of Benton County PA CurrentSince Nov 1, 2017 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jun 28, 2021 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Past Accepting new patients
Bentonville Anesthesia PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

2601 Gene George Blvd
Springdale, AR 72762
Phone (479) 725-6800

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1912937103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251418",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251418",
            "telephone_number": "501-364-1100",
            "fax_number": "803-296-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 GENE GEORGE BLVD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620845",
            "telephone_number": "479-725-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "palmetto health",
            "address_2": "1321 lady street",
            "address_purpose": "LOCATION",
            "city": "columbia",
            "state": "SC",
            "postal_code": "29201",
            "country_code": "US",
            "telephone_number": "803-296-2548",
            "fax_number": "803-296-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRATT",
        "first_name": "JENNY",
        "middle_name": "MARIE ALLEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "2930",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C002615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.