Tucker Family Medicine of Arkansas, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TUCKER FAMILY MEDICINE OF ARKANSAS, INC

Practice address

2905 S Walton Blvd
Ste. 17
Bentonville, AR 72712-6730

Phone

(870) 405-8579

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Donald L Tucker Jr.

Title

Business Manager

Phone

(870) 405-8579

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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

• Katie E Combs, APN

  • Nurse Practitioner
  • Mountain Home, AR
  • NPI 1518155761
  NPD (past)
• Larry Don Wright, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Bella Vista, AR
  • NPI 1255395752
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353024000000",
    "number": "1063508299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SOMERSET",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124091",
            "telephone_number": "479-270-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 S WALTON BLVD",
            "address_2": "STE. 17",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727126730",
            "telephone_number": "870-405-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUCKER FAMILY MEDICINE OF ARKANSAS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-11-16",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "870-405-8579",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158496002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Trost, MS, CCC-SLP, IBCLC
• True Motion LLC
• Brandon Trujillo, DPT
• Trustt Medical PLLC
• Tai Ling Tu
• Justine Tucker, LAC, MHP
• Melinda S Tucker, FNP-C
• Tammy Jean Hale Tucker, D.O.
• Noel C. Tugwell, MPT, MS
• Skye Nicole Turley

• Family Medicine Physician in Bentonville, AR
• Providers in Bentonville, 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 Nov 16, 2012; 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.