The Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

THE CLINIC

Practice address

402 SW Larkspur Dr
Walnut Ridge, AR 72476-1750

Phone

(870) 813-0300

Fax

(870) 313-0380

NPI assigned

Feb 20, 2024

Last updated

Feb 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Kimble

Title

Admin

Phone

(870) 813-0300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1609631415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 SW LARKSPUR DR",
            "city": "WALNUT RIDGE",
            "state": "AR",
            "postal_code": "724761750",
            "telephone_number": "870-813-0300",
            "fax_number": "870-313-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 SW LARKSPUR DR",
            "city": "WALNUT RIDGE",
            "state": "AR",
            "postal_code": "724761750",
            "telephone_number": "870-813-0300",
            "fax_number": "870-313-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "KIMBLE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "870-813-0300"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clay R Spencer, M.D.
• State of Arkansas (Lawrence County Health Unit)
• Michael Leon Steele, QBHP
• Susan Michele Sullivan, PHARMD
• Abbey Michelle Taber, RN, APRN
• Kyra Tucker, QBHP
• Robert Doyle Turner, APRN
• Paul Vellozo, MD
• Walmart Inc.
• Walnut Ridge SNF Operations LLC (Walnut Ridge Nursing and Rehabilitation Center)

• Family Medicine Physician in Walnut Ridge, AR
• Providers in Walnut Ridge, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.