River Valley Primary Care, L.L.C.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

128797 Issued in AR

Legal business name

RIVER VALLEY PRIMARY CARE, L.L.C.

Practice address

107 W Broadway St
Spiro, OK 74959-2417

Phone

(479) 262-6069

NPI assigned

Jun 26, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Frederick Joseph Fuoco

Title

Sole Member

Phone

(504) 495-6772

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1487149043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 GARRISON AVE APT 202",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729011959",
            "telephone_number": "504-495-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W BROADWAY ST",
            "city": "SPIRO",
            "state": "OK",
            "postal_code": "749592417",
            "telephone_number": "479-262-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER VALLEY PRIMARY CARE, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "FUOCO",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "504-495-6772",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "N-5521",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "128797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Spiro, OK
• Providers in Spiro, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.