NPIMap

Organization Active NPI

Uams

Doing business as Family Medical Center AHEC

  • Nurse Practitioner
  • Fort Smith, AR
National Provider Identifier
1710944608
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
UAMS
Doing business as
Family Medical Center AHEC
Practice address
612 S 12TH St
Fort Smith, AR 72901-3892
Phone
(479) 785-2431
Fax
(479) 494-7787
NPI assigned
Apr 26, 2006
Last updated
Sep 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Authorized official

Name
Don Heard, EDD
Title
Director
Phone
(479) 785-2431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

612 S 12TH St
Fort Smith, AR 72901-3892

Mailing address

612 S 12TH St
Fort Smith, AR 72901-3892
Phone (479) 785-2431

Other identifiers 1

IdentifierTypeStateIssuer
159360762MedicaidAR

Other names 1

  • Family Medical Center AHEC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Raymond Bredfeldt MD111 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

Subparts reporting this organization as parent 6

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1710944608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S 12TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729013892",
            "telephone_number": "479-785-2431",
            "fax_number": "479-494-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S 12TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729013892",
            "telephone_number": "479-785-2431",
            "fax_number": "479-494-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "HEARD",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "479-785-2431",
        "authorized_official_credential": "EDD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159360762",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Center AHEC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.