Organization Active NPI

Lofton Family Clinic, MD PA

  • Family Medicine Physician
  • De Queen, AR
National Provider Identifier
1316144306
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E 4640 Issued in AR
Legal business name
LOFTON FAMILY CLINIC, MD PA
Practice address
203 W Dequeen Ave
De Queen, AR 71832-2809
Phone
(870) 642-4000
Fax
(870) 277-4293
NPI assigned
Jul 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Authorized official

Name
Jason D Lofton, MDNPI 1700892734
Title
Owner
Phone
(870) 642-4000

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X E 4640 AR Primary

Addresses

Primary practice location

203 W Dequeen Ave
De Queen, AR 71832-2809

Mailing address

203 W Dequeen Ave
De Queen, AR 71832-2809
Phone (870) 642-4000

Other practice location 1

511 S Park Dr
Broken Bow, OK 74728-5329
Phone (580) 584-6888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080909000334 AR Part B Supplier - Clinic/Group Practice 6800962283 Receives reassigned benefits from 1 practitioner
Practice locations: De Queen, AR
O20240515003032 OK Part B Supplier - Clinic/Group Practice 6800962283 Receives reassigned benefits from 1 practitioner
Practice locations: Broken Bow, OK

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D1071458Lofton Family Clinic203 W Dequeen Ave, De Queen, AR 71832Provider-performed microscopyJul 25, 2027
37D2314083Lofton Family Clinic511 S Park Dr, Ste C, Broken Bow, OK 74728Certificate of waiverNov 12, 2026

National Provider Directory

National Provider Directory

Locations

511 S Park Dr
Broken Bow, OK 74728
Phone (580) 584-6888

105 Main St
Broken Bow, OK 74728

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1316144306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W DEQUEEN AVE",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718322809",
            "telephone_number": "870-642-4000",
            "fax_number": "870-642-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W DEQUEEN AVE",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718322809",
            "telephone_number": "870-642-4000",
            "fax_number": "870-277-4293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 S Park Dr",
            "address_purpose": "LOCATION",
            "city": "Broken Bow",
            "state": "OK",
            "postal_code": "747285329",
            "country_code": "US",
            "telephone_number": "580-584-6888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LOFTON FAMILY CLINIC, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "LOFTON",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-642-4000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E 4640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 2, 2024; 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.