Elevation Family Healthcare, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ELEVATION FAMILY HEALTHCARE, PLLC

Practice address

11112 Shumate Crossing Rd
Farmington, AR 72730

Phone

(479) 530-4744

Fax

(479) 530-4744

NPI assigned

Oct 28, 2025

Organization subpart

No

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

Authorized official

Name

Charlene Mae Jaques, APNPNPI 1376373761

Title

Owner/Employee

Phone

(479) 530-4744

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 1

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

• Charlene Mae Jaques, APN

  • Nurse Practitioner
  • Farmington, AR
  • NPI 1376373761
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1761609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1174491468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11112 SHUMATE CROSSING RD",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727308792",
            "telephone_number": "479-530-4744",
            "fax_number": "479-530-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11112 SHUMATE CROSSING RD",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "72730",
            "telephone_number": "479-530-4744",
            "fax_number": "479-530-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATION FAMILY HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "JAQUES",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "OWNER/EMPLOYEE",
        "authorized_official_telephone_number": "479-530-4744",
        "authorized_official_credential": "APNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makenna Brooke Crawford, LCSW
• Sheri Lynn Davis, LPTA
• Stephanie Jane Dobbins, M.S. C.F. S.L.P.
• Caroline Michelle Dyer, OTD, OTR/L
• Education and Behavioral Consulting Services of Arkansas LLC
• Ava Ellis
• Lindsey Estes
• Samantha Renee Evans, M.S. SLP
• Exceed Physical Therapy, Inc.
• Faith Works on the Spectrum, LLC

• Family Medicine Physician in Farmington, AR
• Providers in Farmington, 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 Oct 28, 2025; 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.