Justin Tedford

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

214777 Issued in AR

Practice address

117 Northridge Dr E Ste C
Van Buren, AR 72956-6983

Phone

(479) 474-4892

NPI assigned

Sep 30, 2026

Last updated

Sep 30, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1790726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1417861121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 NORTHRIDGE DR E STE C",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729566983",
            "telephone_number": "479-474-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 NORTHRIDGE DR E STE C",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729566983",
            "telephone_number": "479-474-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDFORD",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-30",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AR",
            "license": "214777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• The Clinic at the Forging Place
• The Forging Place
• The Guidance Center - Van Buren Clinic
• The Guidance Center- Crawford County Sats

• Licensed Practical Nurse in Van Buren, AR
• Providers in Van Buren, AR by specialty
• Licensed Practical Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.