Russellville Family Clinic PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

RUSSELLVILLE FAMILY CLINIC PA

Practice address

108 Skyline Dr
Russellville, AR 72801-3362

Phone

(479) 968-7170

Fax

(479) 968-7607

NPI assigned

Oct 14, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Joy A Pike

Title

Business Manager

Phone

(479) 968-7170

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lauren Marie Adkison, PA-C

  • Physician Assistant
  • Russellville, AR
  • NPI 1255755260
  NPD (past)
• Vera Collins, MD

  • Family Medicine Physician
  • Fort Smith, AR
  • NPI 1942299482
  NPD (past)
• Andrew Mason Monfee, M.D.

  • Family Medicine Physician
  • Russellville, AR
  • NPI 1447257142
  NPD (past)
• Michael D Kaploe, DO

  • Family Medicine Physician
  • Milford, NH
  • NPI 1073500682
  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1003805870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1648",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728111648",
            "telephone_number": "479-968-7170",
            "fax_number": "479-968-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 SKYLINE DR",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013362",
            "telephone_number": "479-968-7170",
            "fax_number": "479-968-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELLVILLE FAMILY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "PIKE",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "479-968-7170",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119926002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE # ISSUED BY GOVERMENT FOR RAILROAD CLAIMS",
            "identifier": "8772887600",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Russellville Cardiology Consultants, PA
• Russellville Care Center Inc (Russellville Nursing and Rehabilitation Center)
• Russellville Dermatology Clinic PA
• Russellville Ear Nose and Throat Surgery Clinic, P.a.
• Russellville Eye Clinic, P.a.
• Russellville Family Dentistry PA
• Russellville Gastroenterology Clinic PA
• Russellville Gynecology Clinic
• Russellville Holdings LLC (St . Mary's Regional Medical Center)
• Russellville Holdings LLC (Saint Mary's Regional Medical Center Rehab)

• Family Medicine Physician in Russellville, AR
• Providers in Russellville, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.