Individual provider Active NPI

Amber Fawn Adams, MSN, APRN-CNP, FNP-C

  • Family Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1962789826
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
122223 Issued in AR
Practice address
3637 E Johnson Ave Ste B
Jonesboro, AR 72405-1808
Phone
(877) 522-1275
NPI assigned
Nov 7, 2011
Last updated
Sep 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 122223 AR Primary
Family Medicine Physician 207Q00000X 122223 AR

Addresses

Primary practice location

3637 E Johnson Ave Ste B
Jonesboro, AR 72405-1808

Mailing address

5615 Dunbarton Ave
Pasco, WA 99301-8216
Phone (509) 222-1275

Other practice location 1

1000 E Matthews Ave Ste B
Jonesboro, AR 72401-4344
Phone (870) 932-6883

Other practice location 2

402 SW Larkspur Dr
Walnut Ridge, AR 72476
Phone (870) 886-2222

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
I20220728001349 AR Practitioner - Nurse Practitioner 9830571504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1962789826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 DUNBARTON AVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018216",
            "telephone_number": "509-222-1275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 E JOHNSON AVE STE B",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724051808",
            "telephone_number": "877-522-1275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E Matthews Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724014344",
            "country_code": "US",
            "telephone_number": "870-932-6883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "402 SW Larkspur Dr",
            "address_purpose": "LOCATION",
            "city": "Walnut Ridge",
            "state": "AR",
            "postal_code": "72476",
            "country_code": "US",
            "telephone_number": "870-886-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "AMBER",
        "middle_name": "FAWN",
        "credential": "MSN, APRN-CNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-07",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "122223",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "122223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.