Organization Active NPI

Claire Russell Family Medical Center PLLC

  • Family Nurse Practitioner
  • De Queen, AR
National Provider Identifier
1477066264
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
CLAIRE RUSSELL FAMILY MEDICAL CENTER PLLC
Practice address
300 W Collin Raye Dr Ste 101B
De Queen, AR 71832-2003
Phone
(903) 280-2813
NPI assigned
Nov 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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

Authorized official

Name
Katina R Levingston
Title
Manager
Phone
(903) 293-7093

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

300 W Collin Raye Dr Ste 101B
De Queen, AR 71832-2003

Mailing address

300 W Collin Raye Dr Ste 101B
De Queen, AR 71832-2003
Phone (903) 280-2813

National Provider Directory

National Provider Directory

Locations

300 W Collin Raye Dr
Ste 101B
De Queen, AR 71832
Phone (903) 280-2813

NPI Registry JSON

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510704000000",
    "number": "1477066264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W COLLIN RAYE DR STE 101B",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718322003",
            "telephone_number": "903-280-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W COLLIN RAYE DR STE 101B",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718322003",
            "telephone_number": "903-280-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAIRE RUSSELL FAMILY MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-15",
        "last_updated": "2017-11-15",
        "status": "A",
        "authorized_official_last_name": "LEVINGSTON",
        "authorized_official_first_name": "KATINA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "903-293-7093"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "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 Nov 15, 2017; 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.