Organization Active NPI

Falwell Family Medicine, PA

  • Family Medicine Physician
  • Batesville, AR
National Provider Identifier
1740593771
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E4642 Issued in AR
Legal business name
FALWELL FAMILY MEDICINE, PA
Practice address
2201 Harrison St
Batesville, AR 72501-7418
Phone
(870) 307-0264
Fax
(870) 307-0382
NPI assigned
Jul 19, 2010
Last updated
Oct 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name
Dr. Kevin Wade Falwell Jr., M.D.NPI 1356373286
Title
Owner
Phone
(870) 307-0264

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X E4642 AR Primary

Addresses

Primary practice location

2201 Harrison St
Batesville, AR 72501-7418

Mailing address

2201 Harrison St
Batesville, AR 72501-7418
Phone (870) 307-0264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101105001081 AR Part B Supplier - Clinic/Group Practice 5991990715 Receives reassigned benefits from 1 practitioner
Practice locations: Batesville, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2011488Falwell Family Medicine2201 Harrison St, Batesville, AR 72501Certificate of waiverAug 16, 2026

National Provider Directory

National Provider Directory

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": "1279497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1740593771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017418",
            "telephone_number": "870-307-0264",
            "fax_number": "870-307-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017418",
            "telephone_number": "870-307-0264",
            "fax_number": "870-307-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALWELL FAMILY MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-19",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "FALWELL",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-307-0264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E4642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.