Ouachita Family Practice LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A01300-ANP Issued in AR

Legal business name

OUACHITA FAMILY PRACTICE LLC

Practice address

1210 Dequeen St
Mena, AR 71953-4132

Phone

(479) 394-5068

Fax

(479) 394-5626

NPI assigned

Sep 30, 2008

Organization subpart

No

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

Authorized official

Name

Debbie Kincaid

Title

Practice Manager

Phone

(479) 394-5068

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

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

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GFIEAD

Practitioners 6

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

• Ocean Miranda Brewer, APRN-CNP

  • Family Nurse Practitioner
  • Mena, AR
  • NPI 1184254765
  Medicare reassignment Care Compare group NPD
• Debra Inevia Fairless, APN

  • Family Nurse Practitioner
  • Mena, AR
  • NPI 1285805358
  Medicare reassignment Care Compare group NPD
• Bill R McCourtney II, MD

  • Family Medicine Physician
  • Mena, AR
  • NPI 1811985831
  Medicare reassignment Care Compare group NPD
• Lonnie H Sessler, M.D.

  • Family Medicine Physician
  • Mena, AR
  • NPI 1518949429
  Medicare reassignment NPD
• Jenna Christen Campbell, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • De Queen, AR
  • NPI 1790039162
  NPD (past)
• Robert Manis, M.D.

  • Family Medicine Physician
  • Mena, AR
  • NPI 1881682235
  NPD (past)

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385337600000",
    "number": "1225289978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1788",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719531781",
            "telephone_number": "479-394-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 DEQUEEN ST",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534132",
            "telephone_number": "479-394-5068",
            "fax_number": "479-394-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUACHITA FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2013-11-25",
        "status": "A",
        "authorized_official_last_name": "KINCAID",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "479-394-5068"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "N6236",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A01300-ANP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A03080ANP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "5A866",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175314762",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182122002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "5U119",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrienne Michelle Neal, APRN
• Nonna's Care LLC (TruCore Psychiatry)
• Rhonda O'Brien, LPC
• Juliann Daniell Oglesby
• Ouachita Counseling Services
• Ouachita Healing Counseling LLC
• Ouachita Health Services, LLC
• Ouachita Physical Therapy Services Inc (Ouachita Rehabilitation and Fitness Center)
• Ouachita River School District
• Ouachita Senior Community Development, LP (The Oaks at Mena, LLC)

• Family Nurse Practitioner in Mena, AR
• Providers in Mena, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.