Spanish Trace Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SPANISH TRACE CLINIC

Practice address

1205 E 35TH St
Texarkana, AR 71854-2746

Phone

(903) 735-5355

Fax

(903) 735-5399

NPI assigned

Sep 8, 2005

Last updated

Jul 21, 2022By 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

Dr. Jerry B Srtingfellow, MD

Title

Provider

Phone

(903) 735-5355

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Kevin McCann, FNP-BC

  • Family Nurse Practitioner
  • Texarkana, AR
  • NPI 1639125719
  NPD (past)
• Amy Leigh Overton-McCoy, GNP

  • Gerontology Nurse Practitioner
  • Texarkana, AR
  • NPI 1295731545
  NPD (past)
• Rebecca Lynne Botkin, APN

  • Family Nurse Practitioner
  • Conroe, TX
  • NPI 1477799922
  NPD (past)
• Leasa L Roach, GNP

  • Gerontology Nurse Practitioner
  • Texarkana, TX
  • NPI 1326061235
  NPD (past)

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1639163363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 811",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755040811",
            "telephone_number": "903-735-5355",
            "fax_number": "903-735-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 E 35TH ST",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718542746",
            "telephone_number": "903-735-5355",
            "fax_number": "903-735-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPANISH TRACE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SRTINGFELLOW",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "903-735-5355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ8571",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5C286",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "46KU",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southwest Arkansas Counseling & Mental Health Center, Inc
• Southwest Arkansas Counseling and Mental Health Center
• Southwest Arkansas Counseling and Mental Health Center, Inc
• Southwest Arkansas Development Council, Inc.
• Southwest Arkansas Medical Staffing Solutions, PLLC
• Special Health Resources for Texas, Inc. (All for Kids Clinic)
• Special Health Resources for Texas, Incorporated (All for Kids Clinic)
• Shanna Leigh Spence, MD
• Dwight L Sperry, MA
• Linda Lou Spillers-Martin, RN

• Family Medicine Physician in Texarkana, AR
• Providers in Texarkana, 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 Jul 21, 2022; 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.