Spavinaw Clinics, Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

SPAVINAW CLINICS, INC

Practice address

346 N. Main Street
Decatur, AR 72722-0735

Phone

(479) 752-3232

Fax

(479) 752-3235

NPI assigned

Aug 9, 2006

Organization subpart

No

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

Authorized official

Name

Peggy A Beal

Title

Authorized Official

Phone

(479) 752-3233

Specialties & licenses 2

Addresses

Other names 1

• DECATUR MEDI CLINIC Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Sgoh Acquisition Inc

  • Rural Health Clinic/Center
  • Decatur, AR
  • NPI 1699513507

  Sold to, 2024-08-05

  CMS change of ownership

Practitioners 3

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

• Laticia Kay Sheffield, APRN

  • Family Nurse Practitioner
  • Decatur, AR
  • NPI 1871013359

  Single Specialty

  NPD
• Douglas Edmond De Saint-Felix, M.D.

  • Family Medicine Physician
  • Beebe, AR
  • NPI 1487641874
  NPD (past)
• Jesse A Stafford, P.A.-C

  • Medical Physician Assistant
  • Decatur, AR
  • NPI 1316338361
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1023028016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735",
            "city": "DECATUR",
            "state": "AR",
            "postal_code": "727220735",
            "telephone_number": "479-752-3233",
            "fax_number": "479-752-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 N. MAIN STREET",
            "city": "DECATUR",
            "state": "AR",
            "postal_code": "727220735",
            "telephone_number": "479-752-3232",
            "fax_number": "479-752-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPAVINAW CLINICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "479-752-3233"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DECATUR MEDI CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DECATUR MEDI CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mikia Kilcrease, PMHNP-BC
• Melissa Logan, IBCLC
• Sgoh Acquisition Inc
• Laticia Kay Sheffield, APRN
• Tara Skinner
• Jesse A Stafford, P.A.-C
• Meghann R Whatley, FNP
• Wesley Scott Whitacre, PSY.D.

• All providers in Decatur, AR
• Rural Health Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.