Active NPI
Gammon Healthcare Solutions PLLC
- Family Nurse Practitioner
- Texarkana, AR
National Provider Identifier
1245906254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- GAMMON HEALTHCARE SOLUTIONS PLLC
- Practice address
- 1305 Arkansas Blvd Ste 104
Texarkana, AR 71854-1691 - Phone
- (870) 648-1305
- Fax
- (870) 648-1306
- NPI assigned
- Aug 19, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wendy Gammon, FNP
- Title
- Owner
- Phone
- (870) 648-1305
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
1305 Arkansas Blvd Ste 104
Texarkana, AR 71854-1691
Mailing address
PO Box 295
Lockesburg, AR 71846-0295
Phone (870) 289-5865
Other names 1
- Texarkana Family Healthcare
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D2234380 | Texarkana Family Healthcare | Certificate of waiver | Aug 30, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Texarkana, AR
- NPI 1669848156
-
- Family Nurse Practitioner
- Texarkana, AR
- NPI 1558919365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629331200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1629331200000",
"number": "1245906254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 295",
"city": "LOCKESBURG",
"state": "AR",
"postal_code": "718460295",
"telephone_number": "870-289-5865",
"fax_number": "870-289-6993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 ARKANSAS BLVD STE 104",
"city": "TEXARKANA",
"state": "AR",
"postal_code": "718541691",
"telephone_number": "870-648-1305",
"fax_number": "870-648-1306"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GAMMON HEALTHCARE SOLUTIONS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-08-19",
"last_updated": "2021-08-19",
"certification_date": "2021-08-19",
"status": "A",
"authorized_official_last_name": "GAMMON",
"authorized_official_first_name": "WENDY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "870-648-1305",
"authorized_official_credential": "FNP"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Texarkana Family Healthcare",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Texarkana, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.