Community Family Medical LLC
Organization Active NPI Primary Care Clinic/Center · Marion, AR
NPI 1265098552 · NPPES record last updated May 13, 2019
Key facts
- NPI
- 1265098552
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- COMMUNITY FAMILY MEDICAL LLC
- Practice address
- 1139 North Highway 77
Marion, AR 72364-9027 - Phone
- (870) 559-2480
- Fax
- (870) 559-2555
- NPI assigned
- May 13, 2019
- Organization subpart
- No
Authorized official
- Name
- Hilary Hartwig, FNP-C
- Title
- Nurse Practitioner/Owner
- Phone
- (870) 559-2480
Practitioners 4
-
Robin Lynne Phillips, APRN, FNP-C
-
Lana Headley, APN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D2072884 | Community Family Medical, LLC | Certificate of waiver | Jun 4, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200513002342 | AR | Part B Supplier - Clinic/Group Practice | 0648601351 |
Receives reassigned benefits from 4 practitioners Practice locations: Marion, AR |
National Provider Directory
Interoperability endpoints
- https://api.platform.athenahealth.com/15967/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
1139 North Highway 77
Marion, AR 72364-9027
Mailing address
1139 North Highway 77
Marion, AR 72364-9027
Phone (870) 559-2480
Other providers in Marion, AR
- Holley Holbrook Cochran
- Robin McDaniel Coe
- Terrence Coffey
- Lenora Coleman
- Danielle Coles
- Compassions Counseling and Consulting LLC
- Counseling Consultants
- Counseling Consultants Inc.
- Counseling Consultants, Inc
- Counseling Consultants, Inc
All providers in Marion, AR · Primary Care Clinic/Center in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.