NPIMap

Organization Active NPI

Fore Family Practice LLC

  • Rural Health Clinic/Center
  • Cave City, AR
National Provider Identifier
1174961239
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FORE FAMILY PRACTICE LLC
Practice address
307 N Main St
Cave City, AR 72521-9700
Phone
(870) 283-5550
NPI assigned
Jun 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Authorized official

Name
Ms. Amber L Fore, FNP
Title
Owner
Phone
(870) 283-5550

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

307 N Main St
Cave City, AR 72521-9700

Mailing address

307 N Main St
Cave City, AR 72521-9700
Phone (870) 283-5550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130705000131 AR Part A Provider - Rural Health Clinic 7416197918 Practice locations: Cave City, AR
O20140204001346 AR Part B Supplier - Clinic/Group Practice 7416197918 Receives reassigned benefits from 2 practitioners
Practice locations: Cave City, AR

Rural health clinic certification: CCN 043875

Legal name
FORE FAMILY PRACTICE LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 18, 2013
Last certification
Aug 26, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
May 24, 2013 in AR
Enrollment address
307 N Main St
Cave City, AR 72521-9700

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2061591Fore Family Practice LLC307 N Main St, Cave City, AR 72521Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7296/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Amber L Clements-Fore Individual 5% Or Greater Direct Ownership Interest May 24, 2013 100%
W-2 Managing Employee May 24, 2013 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

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": "1370908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1174961239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 N MAIN ST",
            "city": "CAVE CITY",
            "state": "AR",
            "postal_code": "725219700",
            "telephone_number": "870-283-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N MAIN ST",
            "city": "CAVE CITY",
            "state": "AR",
            "postal_code": "725219700",
            "telephone_number": "870-283-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORE FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "FORE",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-283-5550",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cave City, AR

Sources for this page

Verify at the official NPI Registry.