Magnolia Medical, PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MAGNOLIA MEDICAL, PLLC

Practice address

210 Deer Run CV
Heber Springs, AR 72543-9077

Phone

(501) 691-5850

NPI assigned

Mar 26, 2025

Organization subpart

No

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

Authorized official

Name

Tracy Carroll, NURSE PRACTITIONER

Title

Ceo

Phone

(501) 691-5850

Specialties & licenses 1

Addresses

Other names 1

• Magnolia Medical Other name

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

{
    "created_epoch": "1742947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1023810413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 CEDAR PL",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725437910",
            "telephone_number": "501-691-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 DEER RUN CV",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725439077",
            "telephone_number": "501-691-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-26",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-691-5850",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Johanna Belle Lehfeldt, OTR/L
• Danny Gene Lister, MD
• Kimberly Lister, APRN
• Sherry Lynn Lowery
• Lynda Larue Heber Springs Counseling
• Meagan Marks, COTA/L
• Rocky Martin, PHARMD
• Tammy Martin, B.A., MHPP
• John Glen Martinez, LPC
• Rebekah Olivia Martinez, TM

• Clinic/Center in Heber Springs, AR
• Providers in Heber Springs, AR by specialty
• Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.