Faith and Family Medical Providers PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

FAITH AND FAMILY MEDICAL PROVIDERS PLLC

Practice address

363 Highway 371 S
Magnolia, AR 71753-8960

Phone

(573) 202-4070

NPI assigned

May 5, 2022

Organization subpart

No

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

Authorized official

Name

Jacquelyn Bladdick

Title

Human Resources

Phone

(479) 310-5206

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1720723513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 HIGHWAY 371 S",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717538960",
            "telephone_number": "479-310-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 HIGHWAY 371 S",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717538960",
            "telephone_number": "573-202-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH AND FAMILY MEDICAL PROVIDERS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "BLADDICK",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "HUMAN RESOURCES",
        "authorized_official_telephone_number": "479-310-5206"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Ellis
• Emmalee Beene-Gregory DDS
• Martin L Engeran, MS
• Eddie Scott Epperson, O.D
• Erica Danielle Erwin
• Jerome Mark Falkoff, DDS PA
• Ahna Farrar
• Terry Wayne Feyen, PD
• Melissa G Fields
• Christian Brooke Finney, COTA/L

• General Practice Physician in Magnolia, AR
• Providers in Magnolia, AR by specialty
• General Practice Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.