Organization Active NPI

Shared Families of Northwest Arkansas L.L.C.

  • Clinical Social Worker
  • Rogers, AR
National Provider Identifier
1679196992
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SHARED FAMILIES OF NORTHWEST ARKANSAS L.L.C.
Practice address
805 N 20TH PL Ste 1
Rogers, AR 72756-3571
Phone
(479) 274-8271
Fax
(888) 624-0137
NPI assigned
May 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Authorized official

Name
Corey Childs
Title
Owner
Phone
(479) 274-8271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

805 N 20TH PL Ste 1
Rogers, AR 72756-3571

Mailing address

401 N 8TH St # 997
Rogers, AR 72756-3761
Phone (479) 274-8271

National Provider Directory

National Provider Directory

Locations

805 N 20th Pl
Ste 1
Rogers, AR 72756
Phone (479) 274-8271

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1679196992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 8TH ST # 997",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563761",
            "telephone_number": "479-274-8271",
            "fax_number": "479-876-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N 20TH PL STE 1",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563571",
            "telephone_number": "479-274-8271",
            "fax_number": "888-624-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARED FAMILIES OF NORTHWEST ARKANSAS L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-20",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "CHILDS",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-274-8271"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.