Active NPI
Claire Russell Family Medical Center PLLC
- Family Nurse Practitioner
- De Queen, AR
National Provider Identifier
1477066264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 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 DirectoryLocations
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.