Prescott Family Clinic P a

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PRESCOTT FAMILY CLINIC P A

Practice address

301 Hale Ave
Prescott, AR 71857-3330

Phone

(870) 887-6651

Fax

(870) 887-2008

NPI assigned

Mar 30, 2006

Last updated

Sep 9, 2013By 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

Dr. Michael Clarence Young, M.D.NPI 1124026836

Title

President

Phone

(870) 887-6651

Specialties & licenses 1

Addresses

Other identifiers 3

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 2

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.

• Michael Clarence Young, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Prescott, AR
  • NPI 1124026836
  Medicare reassignment NPD Authorized official
• Aimee Hughes, ANP

  • Nurse Practitioner
  • Garland, TX
  • NPI 1306803507
  NPD (past)

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1831150747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HALE AVE",
            "city": "PRESCOTT",
            "state": "AR",
            "postal_code": "718573330",
            "telephone_number": "870-887-6651",
            "fax_number": "870-887-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HALE AVE",
            "city": "PRESCOTT",
            "state": "AR",
            "postal_code": "718573330",
            "telephone_number": "870-887-6651",
            "fax_number": "870-887-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCOTT FAMILY CLINIC P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-30",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CLARENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-887-6651",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "56900",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GBA RAILROAD",
            "identifier": "DG5104",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831150747",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nickolis Perkins
• Jessica Fay Plunk
• PNC, Inc.
• Allison Rae Pogue, LPN
• Crystal D Powell
• Prescott Ops, LLC (Southern Pines Health and Rehab)
• Prescott School District
• Prescott School District
• Prescott SNF Operations, LLC (Southern Pines Health and Rehab)
• Anthony Bayliss Price, MHPP

• Clinic/Center in Prescott, AR
• Providers in Prescott, AR by specialty
• Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.