Organization Active NPI

Teague Family Med & Spa, LLC

  • Family Nurse Practitioner
  • Harrison, AR
National Provider Identifier
1861381709
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
TEAGUE FAMILY MED & SPA, LLC
Practice address
519 N Willow St
Harrison, AR 72601-3518
Phone
(866) 573-4747
Fax
(870) 604-1366
NPI assigned
Jul 2, 2025
Last updated
Aug 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Authorized official

Name
Angela Teague, APRNNPI 1639726862
Title
Owner/Authorized Official
Phone
(479) 968-2109

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 Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

519 N Willow St
Harrison, AR 72601-3518

Mailing address

519 N Willow St
Harrison, AR 72601-3518
Phone (866) 573-4747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250814002795 AR Part B Supplier - Clinic/Group Practice 7012416399 Receives reassigned benefits from 2 practitioners
Practice locations: Harrison, 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
04D2327606Teague Family Med and Spa519 N Willow Street, Harrison, AR 72601Certificate of waiverJul 24, 2027

National Provider Directory

National Provider Directory

Locations

519 N Willow St
Harrison, AR 72601
Phone (866) 573-4747

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1861381709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 N WILLOW ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013518",
            "telephone_number": "866-573-4747",
            "fax_number": "870-604-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 N WILLOW ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013518",
            "telephone_number": "866-573-4747",
            "fax_number": "870-604-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAGUE FAMILY MED & SPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "479-968-2109",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; 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.