NPIMap

Individual provider Active NPI

Kristi Qualls Price, M.D.

  • Family Medicine Physician
  • Lake City, AR
National Provider Identifier
1639136609
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-3986 Issued in AR
Practice address
803 Highway 18
Lake City, AR 72437-9603
Phone
(870) 561-3300
Fax
(870) 561-3307
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-3986 AR Primary

Addresses

Primary practice location

803 Highway 18
Lake City, AR 72437-9603

Mailing address

PO Box 505
Lake City, AR 72437-0505
Phone (870) 237-1055

Other identifiers 1

IdentifierTypeStateIssuer
154227001MedicaidAR

Other names 1

  • Kristi Statler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040614001504 AR Practitioner - Family Practice 6204810773 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Medical Clinic Arkansas LLCGroup PAC ID 5890077093, 143 clinicians
Access Medical Clinic Arkansas LTC LLCGroup PAC ID 0547618175, 141 clinicians
Riverside Medical ClinicGroup PAC ID 5597944157, 2 clinicians

Practice addresses (Care Compare)

104 W State St
Caraway, AR 72419-8553
Phone (870) 895-2015

106 N Van Buren St
Weiner, AR 72479-9289
Phone (870) 605-0014

803 Hwy 18
Lake City, AR 72437-9603
Phone (870) 237-1055

Hospital & facility affiliations

  • St Bernards Home Care Home health agency, Jonesboro, AR, CCN 047033
  • Elite Home Health Home health agency, Jonesboro, AR, CCN 047145
  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020
  • Baptist Memorial Hospital Jonesboro, Inc. Hospital, Jonesboro, AR, CCN 040118
  • Great River Medical Center Hospital, Blytheville, AR, CCN 040069
  • South Mississippi County Regional Medical Center Hospital, Osceola, AR, CCN 040782
  • Quail Run Health and Rehab Nursing home, Trumann, AR, CCN 045480
  • Manila Healthcare Center Nursing home, Manila, AR, CCN 045297
  • Harris Health and Rehab Nursing home, Osceola, AR, CCN 045440
  • Lakeside Health and Rehab Nursing home, Lake City, AR, CCN 045315

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-3986ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Clinic Arkansas LTC LLC Family Medicine CurrentSince Oct 21, 2024 Accepting new patients
Access Medical Clinic Arkansas LLC Family Medicine CurrentSince Feb 1, 2019 Accepting new patients
Access Medical Clinic Arkansas LTC LLC Family Medicine CurrentSince Oct 21, 2024 Accepting new patients
Access Medical Clinic Arkansas LLC Family Medicine CurrentSince Feb 1, 2019 Accepting new patients
Riverside Medical Clinic Family Medicine CurrentSince Nov 27, 2010 Accepting new patients
Northeast Arkansas Clinic, PA Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

104 W State St
Caraway, AR 72419
Phone (870) 565-9205

16723 Highway 62
Garfield, AR 72732
Phone (870) 219-7706

803 Highway 18
Lake City, AR 72437
Phone (870) 237-1055

106 N Van Buren St
Weiner, AR 72479
Phone (870) 605-0014

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Quail Run Health and RehabTrumann, AR, CCN 045480 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2025
Apr 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 16

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1639136609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505",
            "city": "LAKE CITY",
            "state": "AR",
            "postal_code": "724370505",
            "telephone_number": "870-237-1055",
            "fax_number": "870-237-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 HIGHWAY 18",
            "city": "LAKE CITY",
            "state": "AR",
            "postal_code": "724379603",
            "telephone_number": "870-561-3300",
            "fax_number": "870-561-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "KRISTI",
        "middle_name": "QUALLS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-3986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154227001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTI",
            "last_name": "STATLER",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake City, AR

Sources for this page

Verify at the official NPI Registry.