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NPI 1053347633ActiveOrganization· Family Medicine· Fayetteville, AR
Family Medicine in Fayetteville, Arkansas, registered in NPPES in June 2006. The authorized official on file is Denise Grosse, Clinic Administrator.
Overview
| NPI | 1053347633 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 24, 2006 |
| Last updated in NPPES | Nov 7, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | C-8455 | AR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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