Organization Active NPI

Tallah Medical Ar PLLC

  • Family Medicine Physician
  • Bentonville, AR
National Provider Identifier
1043159189
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TALLAH MEDICAL AR PLLC
Practice address
201 SW 14TH St
Bentonville, AR 72712-7449
Phone
(479) 785-2229
Fax
(479) 314-3185
NPI assigned
Mar 25, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Authorized official

Name
Clarisse TallahNPI 1609225499
Title
Owner
Phone
(479) 785-2229

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

201 SW 14TH St
Bentonville, AR 72712-7449

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (479) 785-2229

National Provider Directory

National Provider Directory

Locations

201 SW 14th St
Bentonville, AR 72712
Phone (479) 785-2229

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1774396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774396800000",
    "number": "1043159189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "479-785-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SW 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127449",
            "telephone_number": "479-785-2229",
            "fax_number": "479-314-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLAH MEDICAL AR PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A",
        "authorized_official_last_name": "TALLAH",
        "authorized_official_first_name": "CLARISSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-785-2229"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.