NPIMap

Organization Active NPI

University of Arkansas for Medical Sciences

Doing business as AHEC Family Medical Center

  • Family Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1306191762
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Doing business as
AHEC Family Medical Center
Practice address
612 S 12TH St
Fort Smith, AR 72901-4702
Phone
(479) 785-2431
Fax
(479) 494-7787
NPI assigned
Jul 20, 2012
Last updated
Jul 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Authorized official

Name
Debbie Richardson
Title
Clinic Manager
Phone
(479) 785-2431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

612 S 12TH St
Fort Smith, AR 72901-4702

Mailing address

612 S 12TH St
Fort Smith, AR 72901-4702
Phone (479) 785-2431

Other identifiers 1

IdentifierTypeStateIssuer
159360762MedicaidAR

Other names 1

  • AHEC Family Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Raymond Bredfeldt MD111 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342742400000",
    "number": "1306191762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S 12TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014702",
            "telephone_number": "479-785-2431",
            "fax_number": "479-494-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S 12TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014702",
            "telephone_number": "479-785-2431",
            "fax_number": "479-494-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-20",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "479-785-2431"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159360762",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AHEC Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.