Primary Care 360

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

PRIMARY CARE 360

Doing business as

Urgent Care 360 White Hall

Practice address

103 Frankie LN
White Hall, AR 71602-2685

Phone

(870) 393-5050

NPI assigned

Sep 9, 2020

Last updated

Sep 9, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

PRIMARY CARE 360As reported in NPPES

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

Authorized official

Name

Khalid Rayaz, MDNPI 1023107935

Title

Owner

Phone

(870) 393-5050

Specialties & licenses 2

Addresses

Other names 1

• Urgent Care 360 White Hall Doing business as

Tax ID family

Primary Care 3604 organizations share this tax ID, including this one

Part of

Primary Care 360

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Primary Care 360

  dba Urgent Care 360

  • Urgent Care Clinic/Center
  • Sherwood, AR
  • NPI 1003466319
  NPD tax ID
• Primary Care 360

  • Family Medicine Physician
  • Sherwood, AR
  • NPI 1124678586
  NPD tax ID
• Primary Care 360

  dba Urgent Care 360 Hensley

  • Non-Pharmacy Dispensing Site
  • Hensley, AR
  • NPI 1649885559
  NPD tax ID

Locations

Practitioners 1

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.

• Khalid Rayaz, M.D

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1023107935
  NPD (past) Authorized official

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1134734049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 FRANKIE LN",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716022685",
            "telephone_number": "870-393-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FRANKIE LN",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716022685",
            "telephone_number": "870-393-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE 360",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMARY CARE 360",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "RAYAZ",
        "authorized_official_first_name": "KHALID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-393-5050",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urgent Care 360 White Hall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Pellecer, LMSW
• Deborah Penister, MHPP
• Shannon Perry
• Deborah Mae Pierce, MHPP
• Post-Acute Physicians of Arkansas PLLC
• Ricci R. Ratliff, M.A., CCC-SLP
• Raymed PA (White Hall Walk In Clinic)
• Timmothy Christian Reece, M.D.
• Reynolds Army Community Hospital (Ohc Pine Bluff Arsenal)
• Monica Robertson, QBHP

• Non-Pharmacy Dispensing Site in White Hall, AR
• Providers in White Hall, AR by specialty
• Non-Pharmacy Dispensing Site in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.