NPIMap

Organization Active NPI

Urgent Team of Arkansas Physicians, LLC

  • Rural Health Clinic/Center
  • Harrison, AR
National Provider Identifier
1477286177
Registry record updated Mar 21, 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
808 Highway 62 65 N
Harrison, AR 72601-2151
Phone
(870) 204-7263
Fax
(870) 280-3270
NPI assigned
Jul 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 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

808 Highway 62 65 N
Harrison, AR 72601-2151

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
O20220817003036 AR Part A Provider - Rural Health Clinic 1850539198 Practice locations: Harrison, AR

Rural health clinic certification: CCN 043922

Legal name
URGENT TEAM OF ARKANSAS PHYSICIANS LLC
Doing business as
WASHINGTON REGIONAL URGENT CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 6, 2022
Last certification
Dec 6, 2022
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Oct 22, 2012 in IN
Enrollment address
808 US Hwy 65
Harrison, AR 72601-2151

Other NPIs with the same Medicare PAC ID 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2169486Washington Regional Urgent Care-Harrison,Ar808 US 65, Harrison, AR 72601Certificate of waiverJul 21, 2027

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.

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 DirectorDirector 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

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": "1742515200000",
    "number": "1477286177",
    "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": "808 HIGHWAY 62 65 N",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012151",
            "telephone_number": "870-204-7263",
            "fax_number": "870-280-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT TEAM OF ARKANSAS PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "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 Harrison, AR

Sources for this page

Verify at the official NPI Registry.