Individual provider Active NPI

Philip Ray Faughn, APRN

  • Acute Care Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1932664067
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
A006105 Issued in AR
Practice address
225 E Jackson Ave
Jonesboro, AR 72401-3119
Phone
(870) 207-4100
NPI assigned
Feb 3, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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 A006105 AR Primary

Addresses

Primary practice location

225 E Jackson Ave
Jonesboro, AR 72401-3119

Mailing address

5403 Shad Dr
Jonesboro, AR 72404-9419
Phone (870) 919-0648

Other identifiers 1

IdentifierTypeStateIssuer
A006105MedicaidAR

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
I20190403003034 AR Practitioner - Nurse Practitioner 3274874060 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Medical Center Inc. Current Accepting new patients
St Bernards Hospital Inc. CurrentSince Mar 11, 2019 Accepting new patients
Five Rivers Medical Center CurrentSince Sep 1, 2025 Accepting new patients
Five Rivers Medical Center Inc. CurrentSince Sep 1, 2025 Accepting new patients

Locations

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630

2801 Medical Center Dr
Pocahontas, AR 72455
Phone (870) 892-6000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1549152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1932664067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5403 SHAD DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049419",
            "telephone_number": "870-919-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E JACKSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013119",
            "telephone_number": "870-207-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUGHN",
        "first_name": "PHILIP",
        "middle_name": "RAY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-03",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A006105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A006105",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.