NPIMap

Organization Active NPI

Ivey Family Medicine

  • Primary Care Clinic/Center
  • Bentonville, AR
National Provider Identifier
1932539624
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
R-4023 Issued in AR
Legal business name
IVEY FAMILY MEDICINE
Practice address
2905 S Walton Blvd.
Suite 17
Bentonville, AR 72712-7848
Phone
(479) 657-6501
Fax
(479) 657-6375
NPI assigned
Nov 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Authorized official

Name
Traci Ivey, MDNPI 1831157858
Title
Proprietor/Physician
Phone
(479) 657-6501

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
Primary Care Clinic/Center 261QP2300X R-4023 AR Primary

Addresses

Primary practice location

2905 S Walton Blvd.
Suite 17
Bentonville, AR 72712-7848

Mailing address

PO Box 3570
Bentonville, AR 72712-7718
Phone (479) 657-6501

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1932539624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3570",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127718",
            "telephone_number": "479-657-6501",
            "fax_number": "479-657-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 S WALTON BLVD.",
            "address_2": "SUITE 17",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127848",
            "telephone_number": "479-657-6501",
            "fax_number": "479-657-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVEY FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "IVEY",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "PROPRIETOR/PHYSICIAN",
        "authorized_official_telephone_number": "479-657-6501",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": "R-4023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.