JACKSON PAYNE NPI 1194407379

NPI Information

NPI: 1194407379
Provider Name: JACKSON PAYNE
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
2708 S RIFE MEDICAL LN STE 210
ROGERS, AR
ZIP 72758
Phone: (479) 338-3888
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Jackson Payne is a primary care nurse practitioner in Rogers, AR with 1 years of experience. Jackson Payne NPI is 1194407379. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2708 S RIFE MEDICAL LN STE 210
ROGERS, AR
ZIP 72758-456
Phone: (479) 338-3888

The NPI 1194407379 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/7/2023 and was last updated on 1/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	226845	ARKANSAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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