Organization Active NPI

Hamby & Hamby Family Wellness Clinic PLLC

  • Family Medicine Physician
  • Van Buren, AR
National Provider Identifier
1063618346
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E0957 Issued in AR
Legal business name
HAMBY & HAMBY FAMILY WELLNESS CLINIC PLLC
Practice address
30 Northridge Dr
Van Buren, AR 72956-6668
Phone
(479) 420-4575
NPI assigned
Jun 25, 2007
Last updated
Aug 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Tamara Hamby
Title
Office Manager
Phone
(479) 922-9355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X E0957 AR Primary

Addresses

Primary practice location

30 Northridge Dr
Van Buren, AR 72956-6668

Mailing address

PO Box 6968
Van Buren, AR 72956-0961
Phone (479) 420-4575

Other practice location 1

708 Pirates Way
Cedarville, AR 72932-9506
Phone (479) 922-9355 ext. 108

Other identifiers 1

IdentifierTypeStateIssuer
131118001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070913000621 AR Part B Supplier - Clinic/Group Practice 4587758149 Receives reassigned benefits from 2 practitioners
Practice locations: Van Buren, AR

National Provider Directory

National Provider Directory

Locations

20 N RDG Dr
Van Buren, AR 72956

2010 Chestnut St
Ste I
Van Buren, AR 72956
Phone (479) 420-4575

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1063618346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6968",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729560961",
            "telephone_number": "479-420-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NORTHRIDGE DR",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729566668",
            "telephone_number": "479-420-4575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "708 Pirates Way",
            "address_purpose": "LOCATION",
            "city": "Cedarville",
            "state": "AR",
            "postal_code": "729329506",
            "country_code": "US",
            "telephone_number": "479-922-9355 x108",
            "fax_number": "479-922-2047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HAMBY & HAMBY FAMILY WELLNESS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "HAMBY",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-922-9355"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E0957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131118001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Buren, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.