Board Certified Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BOARD CERTIFIED FAMILY PRACTICE

Practice address

527 North Sixth Street
Blytheville, AR 72315-2790

Phone

(870) 763-4541

Fax

(870) 762-2390

NPI assigned

May 22, 2007

Last updated

Mar 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Lynn Smith

Title

Office Manager

Phone

(870) 763-7695

Specialties & licenses 1

Addresses

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.

• Bridgette Leann Fender, APRN

  • Family Nurse Practitioner
  • Paragould, AR
  • NPI 1922622505
  NPD

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1336358407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 NORHT SIXTH ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152790",
            "telephone_number": "870-763-4541",
            "fax_number": "870-762-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 NORTH SIXTH STREET",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152790",
            "telephone_number": "870-763-4541",
            "fax_number": "870-762-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD CERTIFIED FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-763-7695",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiara M Black
• Robert Austin Blue, PHARMD
• Blytheville Citizens Band Radio Club Inc
• Blytheville Pediatric Dentistry, PLLC (Children's Dental Group)
• Blytheville RT Associates LLC
• Deanna Renee Bogard
• Sarah Boling
• Heidi Bonifacio
• Gregory Mitchell Boswell
• Anita Kay Brackin

• Family Medicine Physician in Blytheville, AR
• Providers in Blytheville, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.