Westside Family Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

WESTSIDE FAMILY CLINIC LLC

Practice address

3812 W Main St
Russellville, AR 72801-2314

Phone

(479) 968-1245

NPI assigned

May 19, 2023

Last updated

May 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey BosoldNPI 1396941522

Title

Ceo

Phone

(479) 747-2641

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 11

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.

• Jeffrey Karl Bosold, APN

  • Family Nurse Practitioner
  • Russellville, AR
  • NPI 1396941522
  Medicare reassignment Care Compare group NPD Authorized official
• Andrew Mason Monfee, M.D.

  • Family Medicine Physician
  • Russellville, AR
  • NPI 1447257142
  Medicare reassignment Care Compare group NPD
• Ana Moua, FNP-BC

  • Family Nurse Practitioner
  • Atkins, AR
  • NPI 1578364212
  Medicare reassignment Care Compare group NPD
• Margaret Danielle Mullins-Moats, FNP-C

  • Family Nurse Practitioner
  • Russellville, AR
  • NPI 1114418993
  Medicare reassignment Care Compare group NPD
• Elizabeth Rehm, MS, RD, LD, CDE

  • Registered Dietitian
  • Russellville, AR
  • NPI 1386896801
  Medicare reassignment Care Compare group NPD
• Sydni Gibbs

  • Family Nurse Practitioner
  • Clarksville, AR
  • NPI 1518505833
  Medicare reassignment NPD
• Aleksi Hipps, APRN

  • Family Nurse Practitioner
  • Russellville, AR
  • NPI 1740922962
  Medicare reassignment NPD
• William Alan Maxwell-Walker, APRN

  • Family Nurse Practitioner
  • Russellville, AR
  • NPI 1215454178
  Medicare reassignment NPD
• Terri Jean McKown, FNP, APN

  • Family Nurse Practitioner
  • Russellville, AR
  • NPI 1174835649
  Medicare reassignment NPD
• Lauren Murchison, APRN

  • Family Nurse Practitioner
  • Russellville, AR
  • NPI 1245087923
  Medicare reassignment NPD
• Jessica Louise McNeese, APN

  • Family Nurse Practitioner
  • Russellville, AR
  • NPI 1770927121
  NPD (past)

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1801587779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012314",
            "telephone_number": "479-968-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "BOSOLD",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "479-747-2641"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phyllis Wells, CASE MANAGER CASE CO
• Steven A. Wells, DNP
• Thomas Gerard Werner, D.P.M.
• Cheyanna Wester
• Tammy Weston
• Abigail Jordan Whatley, COTA
• Dennis E Wheelus
• Cashawna Lefaye Whitaker
• Jennifer Lynn White
• Ronald Lynn White, M.D.

• Family Nurse Practitioner in Russellville, AR
• Providers in Russellville, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.