Organization Active NPI

Dr. Kumar'S Medical Clinic PA

  • Specialist
  • Forrest City, AR
National Provider Identifier
1790718369
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R4521 Issued in AR
Legal business name
DR. KUMAR'S MEDICAL CLINIC PA
Practice address
1801 Lindauer Rd
Forrest City, AR 72335-2407
Phone
(870) 633-5016
Fax
(870) 633-6309
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Authorized official

Name
Ms. Alison Shepherd, APRNNPI 1619460813
Title
President
Phone
(870) 633-5016

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X R4521 AR Primary

Addresses

Primary practice location

1801 Lindauer Rd
Forrest City, AR 72335-2407

Mailing address

1801 Lindauer Rd
Forrest City, AR 72335-2407
Phone (870) 633-5016

Other identifiers 1

IdentifierTypeStateIssuer
126650002MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041020001344 AR Part B Supplier - Clinic/Group Practice 7416918677 Receives reassigned benefits from 2 practitioners
Practice locations: Forrest City, 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
04D0897668Dr Kumar'S Medical Clinic, PA1801 Lindauer Road, Forrest City, AR 72335Provider-performed microscopyJan 17, 2028

National Provider Directory

National Provider Directory

Locations

1600 Lindauer Rd
Forrest City, AR 72335
Phone (870) 633-3551

Practitioners & affiliated clinicians

Practitioners 3

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": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785110400000",
    "number": "1790718369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 LINDAUER RD",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352407",
            "telephone_number": "870-633-5016",
            "fax_number": "870-633-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 LINDAUER RD",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352407",
            "telephone_number": "870-633-5016",
            "fax_number": "870-633-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KUMAR'S MEDICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-633-5016",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AR",
            "license": "R4521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126650002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forrest City, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.