COMMUNITY CLINIC PEA RIDGE – NPI #1669099073
Clinic/Center

COMMUNITY CLINIC PEA RIDGE is an AHC clinic located in PEA RIDGE, AR. NPPES has assigned the NPI number 1669099073 to COMMUNITY CLINIC PEA RIDGE on July 01, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “COMMUNITY CLINIC PEA RIDGE” is a dba name, the actual legal business name for this organization is ST FRANCIS HOUSE NWA, INC. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 6 years ago on Aug 04, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COMMUNITY CLINIC PEA RIDGE below.

NPI Profile for
ST FRANCIS HOUSE NWA, INC

NPI Number
1669099073
Enumeration Date

(about 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ST FRANCIS HOUSE NWA, INC
Doing Business As (dba): COMMUNITY CLINIC PEA RIDGE
Primary location
1923 W PICKENS ROAD
PEA RIDGE, AR 72751
Phone: (479) 751-7417 Fax: (479) 751-4898
Mailing address
614 E EMMA AVE STE 300
SPRINGDALE, AR 72764-4469
Phone: (479) 751-7417 Fax:
Organization Subpart
No
Authorized Official
JAMES SEMINGSON
CEO
Phone: (479) 751-7417
Updated
Certification Date
Aug 04, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.