NPIMap

Organization Active NPI

Urgent Team of Arkansas Physicians, LLC

  • Rural Health Clinic/Center
  • Wynne, AR
National Provider Identifier
1386377083
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
URGENT TEAM OF ARKANSAS PHYSICIANS, LLC
Practice address
411 Falls Blvd S
Wynne, AR 72396-3501
Phone
(870) 238-3261
Fax
(870) 238-3115
NPI assigned
Jul 8, 2022
Last updated
Mar 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Authorized official

Name
Stephanie Hicks
Title
Controller
Phone
(615) 988-2004

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

411 Falls Blvd S
Wynne, AR 72396-3501

Mailing address

30 Burton Hills Blvd Ste 175
Nashville, TN 37215-6403
Phone (615) 988-2009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220824000150 AR Part A Provider - Rural Health Clinic 1850539198 Practice locations: Wynne, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386377083. Details of each certification follow.

Rural health clinic certification: CCN 043924

Legal name
URGENT TEAM OF ARKANSAS PHYSICIANS LLC
Doing business as
BAPTIST URGENT CARE - WYNNE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 6, 2022
Last certification
Sep 10, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Oct 22, 2012 in IN
Enrollment address
411 Falls Blvd S
Wynne, AR 72396

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Urgent Team of Ar Phys LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

123 Audubon Dr
Ste 600
Maumelle, AR 72113
Phone (501) 734-0251

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stephanie Hicks Individual Corporate DirectorController Dec 3, 2024
W-2 Managing EmployeeController Dec 3, 2024
Rudy L Blank Individual Corporate DirectorCfo Oct 1, 2017
Kaylan Kirby Individual W-2 Managing EmployeeBilling Manager Oct 1, 2017
Crystal Gibson Individual W-2 Managing EmployeeCredentialing Manager Jun 6, 2022

Practitioners & affiliated clinicians

Practitioners 2

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": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1386377083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BURTON HILLS BLVD STE 175",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156403",
            "telephone_number": "615-988-2009",
            "fax_number": "615-250-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963501",
            "telephone_number": "870-238-3261",
            "fax_number": "870-238-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT TEAM OF ARKANSAS PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "615-988-2004"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynne, AR

Sources for this page

Verify at the official NPI Registry.