Face 2 Face PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

FACE 2 FACE PLLC

Practice address

1306 Sylvan Hills Rd
Van Buren, AR 72956-2565

Phone

(479) 208-3471

Fax

(888) 987-1841

NPI assigned

Dec 27, 2012

Organization subpart

No

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

Authorized official

Name

Jonathan Rene Broniste, APNNPI 1275774440

Title

Owner

Phone

(479) 208-3471

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 2

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

• Jonathan Rene Broniste, APN

  • Nurse Practitioner
  • Lavaca, AR
  • NPI 1275774440
  Medicare reassignment NPD Authorized official
• Carolyn M Dillard, D.O.

  • Family Medicine Physician
  • Van Buren, AR
  • NPI 1396790721
  Medicare reassignment NPD

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1730425448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140",
            "city": "LAVACA",
            "state": "AR",
            "postal_code": "729410140",
            "telephone_number": "479-674-9181",
            "fax_number": "479-674-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 SYLVAN HILLS RD",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729562565",
            "telephone_number": "479-208-3471",
            "fax_number": "888-987-1841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACE 2 FACE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-27",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "BRONISTE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-208-3471",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198286004",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Letzy Falcon
• Amberlyn Monique Faldon
• Kendra L Fanning, CCC-SLP
• Staysha Carrol Faught
• Dorothy Fenwick, CRNA

• Primary Care Clinic/Center in Van Buren, AR
• Providers in Van Buren, AR by specialty
• Primary Care Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.