NPIMap

Organization Active NPI

Forrest City Clinic Company LLC

  • Internal Medicine Physician
  • Forrest City, AR
National Provider Identifier
1821293051
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FORREST CITY CLINIC COMPANY LLC
Practice address
1601 Newcastle Road
Forrest City, AR 72336
Phone
(870) 261-0000
NPI assigned
Jun 18, 2007
Last updated
Jan 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Authorized official

Name
Laura J Fey
Title
Sr Director Physician Practice Rev
Phone
(615) 221-3641

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU

Addresses

Primary practice location

1601 Newcastle Road
Forrest City, AR 72336

Mailing address

1601 Newcastle Road
Forrest City, AR 72336
Phone (870) 261-0000

Other identifiers 2

IdentifierTypeStateIssuer
166132002MedicaidAR
5F850OtherARBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071024000213 AR Part B Supplier - Clinic/Group Practice 1557457447 Receives reassigned benefits from 21 practitioners
Practice locations: Wynne, AR; West Memphis, AR; Helena, AR; Forrest City, AR; De Witt, AR

National Provider Directory

National Provider Directory

Locations

902 Holiday Dr
Ste 103
Forrest City, AR 72335
Phone (870) 630-9407

902 Holiday Dr
Ste 105
Forrest City, AR 72335
Phone (870) 261-0123

902 Holiday Dr
Ste 106
Forrest City, AR 72335
Phone (870) 494-3025

1803 Martin Luther King Jr Dr
Ste A
Helena, AR 72342
Phone (870) 338-7441

1803 Martin Luther King Jr Dr
Ste C
Helena, AR 72342
Phone (870) 816-3830

1803 Martin Luther King Jr Dr
Ste D
Helena, AR 72342
Phone (870) 816-3800

210 S Rhodes St
West Memphis, AR 72301
Phone (870) 732-5448

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1607/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1821293051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 NEWCASTLE ROAD",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "72336",
            "telephone_number": "870-261-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NEWCASTLE ROAD",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "72336",
            "telephone_number": "870-261-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORREST CITY CLINIC COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR DIRECTOR PHYSICIAN PRACTICE REV",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166132002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5F850",
            "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 Jan 19, 2022; 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.