Family Practice Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

N6056 Issued in AR

Legal business name

FAMILY PRACTICE CENTER

Practice address

194 Shakerag Road
Clinton, AR 72031

Phone

(501) 745-2800

Fax

(501) 745-8864

NPI assigned

Aug 5, 2007

Last updated

Sep 23, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Brenda Lynn Smith

Title

Office Manager

Phone

(501) 745-2800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FGIHAA

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jose Abiseid, M.D.

  • Family Medicine Physician
  • Clinton, AR
  • NPI 1154391514
  Medicare reassignment Care Compare group NPD
• Caitlin Abiseid Shull, APRN

  • Family Nurse Practitioner
  • Clinton, AR
  • NPI 1437668175
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316736000000",
    "number": "1013108240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1100",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "720311100",
            "telephone_number": "501-745-2800",
            "fax_number": "501-745-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 SHAKERAG ROAD",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "72031",
            "telephone_number": "501-745-2800",
            "fax_number": "501-745-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2011-09-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-745-2800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": "N6056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106212001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juliana Elm
• Audrey Emberton, CMP
• Jayne Evans, RN
• Exzabe Chiropractic and Wellness, PLLC
• Jayden Exzabe
• Melissa Farris
• Storm Fedder
• Charles Fogle, RECOVERY ASSISTANT
• Shanean Fulbright
• Furgerson Health Care Inc

• Primary Care Clinic/Center in Clinton, AR
• Providers in Clinton, AR by specialty
• Primary Care Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.