Organization Active NPI

Nomad Family Medical LLC

  • Primary Care Nurse Practitioner
  • Searcy, AR
National Provider Identifier
1861909046
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
A003845 Issued in AR
Legal business name
NOMAD FAMILY MEDICAL LLC
Practice address
404 Lake Wood Dr
Searcy, AR 72143-9056
Phone
(501) 593-6997
NPI assigned
Jan 9, 2018
Last updated
Jan 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Authorized official

Name
Ms. Amber Delise Townsend
Title
Office Manager
Phone
(501) 201-0204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X A003845 AR Primary

Addresses

Primary practice location

404 Lake Wood Dr
Searcy, AR 72143-9056

Mailing address

998 Highway 87
Bradford, AR 72020-9533

Other identifiers 1

IdentifierTypeStateIssuer
198628758MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180228000228 AR Part B Supplier - Clinic/Group Practice 9638430044 Receives reassigned benefits from 1 practitioner
Practice locations: Searcy, AR

National Provider Directory

National Provider Directory

Locations

1311 E Race Ave
Searcy, AR 72143
Phone (501) 203-4225

Practitioners & affiliated clinicians

Practitioners 5

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": "1515456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1861909046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 HIGHWAY 87",
            "city": "BRADFORD",
            "state": "AR",
            "postal_code": "720209533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 LAKE WOOD DR",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721439056",
            "telephone_number": "501-593-6997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOMAD FAMILY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-09",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "TOWNSEND",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "DELISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-201-0204",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AR",
            "license": "A003845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198628758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Searcy, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; 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.