NPIMap

Organization Active NPI

DQH&W Walk in Family Clinic LLC

Doing business as De Queen Clinical Pharmacy Services

  • Family Nurse Practitioner
  • De Queen, AR
National Provider Identifier
1285304949
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
DQH&W WALK IN FAMILY CLINIC LLC
Doing business as
De Queen Clinical Pharmacy Services
Practice address
1357 W Collin Raye Dr
De Queen, AR 71832-2946
Phone
(870) 642-2400
NPI assigned
Sep 15, 2021
Last updated
Jun 27, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
DQH&W WALK IN FAMILY CLINIC, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Mr. Chester Lee Barber Jr., P.D.NPI 1972610293
Title
Pharmacist/Owner
Phone
(870) 642-2400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1357 W Collin Raye Dr
De Queen, AR 71832-2946

Mailing address

1357 W Collin Raye Dr
De Queen, AR 71832-2946
Phone (870) 642-2400

Other names 1

  • De Queen Clinical Pharmacy Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150423000705 AR Part B Supplier - Clinic/Group Practice 5597083626 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: De Queen, AR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
De Queen Clinical Pharmacy Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1357 W Collin Raye Dr
De Queen, AR 71832
Phone (870) 642-2000

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1285304949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1357 W COLLIN RAYE DR",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718322946",
            "telephone_number": "870-642-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 W COLLIN RAYE DR",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718322946",
            "telephone_number": "870-642-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DQH&W WALK IN FAMILY CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DQH&W WALK IN FAMILY CLINIC, LLC",
        "enumeration_date": "2021-09-15",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "BARBER",
        "authorized_official_first_name": "CHESTER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "870-642-2400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "P.D."
    },
    "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": "De Queen Clinical Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "De Queen Clinical Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in De Queen, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.