McCrory Family Clinic PA

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

MC-1803 Issued in AR

Legal business name

MCCRORY FAMILY CLINIC PA

Practice address

908 N Edmonds Ave
McCrory, AR 72101

Phone

(870) 731-1100

Fax

(870) 731-1019

NPI assigned

Aug 30, 2006

Last updated

Jun 9, 2008By 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

Fred E Wilson, MD

Title

MD

Phone

(870) 731-1100

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

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.

• Timothy Michael Pruitt, DNP

  • Nurse Practitioner
  • Southaven, MS
  • NPI 1295738706
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1972613743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "MCCRORY",
            "state": "AR",
            "postal_code": "72101",
            "telephone_number": "870-731-1100",
            "fax_number": "870-731-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 N EDMONDS AVE",
            "city": "MCCRORY",
            "state": "AR",
            "postal_code": "72101",
            "telephone_number": "870-731-1100",
            "fax_number": "870-731-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCRORY FAMILY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "870-731-1100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "AR",
            "license": "MC-1803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134056002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134474729",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI5031",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Laughlin
• Erica Lemasters McCorkle
• Laura Loewer, QBHP
• Marty J Lute, PHARM.D.
• Michael Lee Martin, PHARMD
• McCrory School District
• Laura Beth Mitchell, PT
• Rebecca Jane O'Shields, APRN
• Pilcher Inc (S&H Pharmacy)
• Rebecca Ann Pilcher, PHARMD

• Rural Health Clinic/Center in McCrory, AR
• Providers in McCrory, AR by specialty
• Rural Health Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.