SHENIKA JACKSON-KING (APRN) – Family Nurse Practitioner, NPI 1669886552
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,410 NURSE PRACTITIONER in AR
Provider Addresses for SHENIKA JACKSON-KING (APRN)
106 E SPEEDWAY ST
DERMOTT, AR 716382317
Phone: (870) 538-5414
Fax: (870) 538-5412
Type: Mailing
342 HIGHWAY 425 S
MONTICELLO, AR 716554612
Phone: (870) 942-3000
Fax: (870) 942-3005
Type: Mailing
300 S SCHOOL ST
DERMOTT, AR 716382127
Phone: (870) 538-5296
Fax: (870) 538-3701
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-12-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20141022002466 | I | Nurse Practitioner | AR | TBD |
| I20231211003767 | I | Nurse Practitioner | LA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 71638)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | AR | |
| - | AR | |
| Nurse Practitioner | AR | |
| Nurse Practitioner | AR | |
| Nurse Practitioner | AR | |
| - | AR | |
| Nurse Practitioner | AR | |
| - | AR | |
| Nurse Practitioner | AR | |
| - | AR |
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