Ouachita Physician Services, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OUACHITA PHYSICIAN SERVICES, LLC

Practice address

415 Hospital Dr Ste 4
Camden, AR 71701-4651

Phone

(870) 837-2530

Fax

(870) 836-1358

NPI assigned

Oct 22, 2019

Organization subpart

No

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

Authorized official

Name

Peggy L Abbott

Title

Authorized Official

Phone

(870) 836-1200

Specialties & licenses 1

Addresses

Other names 1

• Family Clinic of Ouachita County Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Ouachita Physician Services

  • Primary Care Clinic/Center
  • Camden, AR
  • NPI 1750651857

  O20120308000662

  Same enrollment
• Ouachita Physician Services, LLC

  • Surgery Physician
  • Camden, AR
  • NPI 1215479159

  O20120308000662

  Same enrollment
• Ouachita Physician Services, LLC

  • Multi-Specialty Clinic/Center
  • Camden, AR
  • NPI 1235526476

  O20120308000662

  Same enrollment

Locations

Practitioners 2

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

• Michael G Campbell, MD

  • Obstetrics & Gynecology Physician
  • Mountain Home, AR
  • NPI 1639135775
  NPD
• Cimenga M Tshibaka, M.D.

  • Surgery Physician
  • Camden, AR
  • NPI 1851459697
  NPD

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571702400000",
    "number": "1467095463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "855-498-6766",
            "fax_number": "479-968-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 HOSPITAL DR STE 4",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717014651",
            "telephone_number": "870-837-2530",
            "fax_number": "870-836-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUACHITA PHYSICIAN SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "870-836-1200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Clinic of Ouachita County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ouachita County Medical Services
• Ouachita Enrichment Centers, Inc.
• Ouachita Physician Services
• Ouachita Physician Services, LLC
• Ouachita Physician Services, LLC
• Abigail Grace Parker, PHARM D
• Perkins & Arnold, PLLC
• Joannie Phelps, LAC
• Mark E. Pickett, DDS
• Jeana Pierce

• All providers in Camden, AR
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.