PRIMARY CARE 360 (NPI# 1124678586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124678586 |
| Entity Type | Organization |
| Organization Name | PRIMARY CARE 360 |
| Practice Address |
100 Shadow Oaks Dr Sherwood AR 72120-6046 |
| Practice Telephone | 5014864045 |
| Mailing Telephone | 5014864045 |
| Mailing Fax Number | 8882135007 |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2020-10-21 |
| Authorized Official Name | DR. KHALID RAYAZ (OWNER) |
| Authorized Official Telephone | 5018334001 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | STATE LICENSE | E-4732 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 S Shackleford Rd, Little Rock, AR 722115725 | 5019189192 | 5012957679 |
| 103 Frankie Ln, White Hall, AR 716022685 | 8703935050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134734049 | Primary Care 360 | Family Medicine | 103 Frankie Ln, White Hall, AR 71602-2685 | 2020-09-09 |
| 1649885559 | Primary Care 360 | Family Medicine | 20602 Arch Street Pike, Hensley, AR 72065-9442 | 2020-09-09 |
| 1003466319 | Primary Care 360 | Clinic/Center | 100 Shadow Oaks Dr, Sherwood, AR 72120-6046 | 2019-09-18 |
| Street Address |
100 SHADOW OAKS DR |
| City | SHERWOOD |
| State | AR |
| Zip Code | 72120-6046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811385602 | Pa and Associates LLC | Clinic/Center | 100 Shadow Oaks Dr, Sherwood, AR 72120-6046 | 2014-12-31 |
| 1538781208 | American Hope and Health Clinic Associates LLC | Internal Medicine | 100 Shadow Oaks Dr, Sherwood, AR 72120-6046 | 2020-05-15 |
| 1003466319 | Primary Care 360 | Clinic/Center | 100 Shadow Oaks Dr, Sherwood, AR 72120-6046 | 2019-09-18 |
| 1992279905 | Ncsa Pllc | Psychiatry & Neurology | 100 Shadow Oaks Dr, Sherwood, AR 72120-6046 | 2019-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215409818 | Mary Kaye Hill | Physical Therapist | 6020 Warden Road, Sherwood, AR 72120 | 2018-12-20 |
| 1043714694 | Healthcare Express, LLP | Clinic/Center | 1554 Country Club Road, Sherwood, AR 72120 | 2018-03-20 |
| 1265957690 | Darryl Nathaniel Griffith | Massage Therapist | 9871 Brockington Road, Suite #1, Sherwood, AR 72120 | 2017-08-07 |
| 1669841011 | Sarah Katherine Stephenson | Pharmacist | 102 Brockington Rd, Sherwood, AR 72120 | 2015-09-16 |
| 1063803328 | The Legacy for Children and Families | Counselor | 190 Jan Drive, Suite #10, Sherwood, AR 72120 | 2015-02-09 |
| 1417297235 | Andrew Hunter Beavers | Counselor | 37 Walton Rd., Sherwood, AR 72120 | 2013-02-15 |
| 1003156886 | Infinity Hearing Center Inc. | Hearing Aid Equipment | 3115 E Kiehl Ave, Suite B, Sherwood, AR 72120 | 2013-02-15 |
| 1548543234 | Lorrie Ann George | Early Intervention Provider Agency | 207 Fred Rains Drive, Sherwood, AR 72120 | 2011-09-20 |
| 1033411897 | Tessa Monique Davis | Occupational Therapist | 21 Gunstock Lane, North Little Rock, AR 72120 | 2010-11-30 |
| 1720307903 | Yousef Arfan Fahoum | Psychologist | 2215 Wildwood Ave Ste 200, Sherwood, AR 72120 | 2010-05-27 |
| Find all providers in zip 72120 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083934632 | James Edward Wilkerson IIi | Family Medicine | 7709 Highway 107, Sherwood, AR 72120-4661 | 2010-06-06 |
| 1841496023 | Mark D Dunn | Family Medicine | 16770 Sw Edy Road, Sherwood, OR 97140-9678 | 2007-06-25 |
| 1861420788 | Maggie K Yu | Family Medicine | 20115 Sw Pacific Hwy, Suite 221, Sherwood, OR 97140-4949 | 2006-06-29 |
| 1194719518 | Clint Thurmond Seymour | Family Medicine | 2201 Wildwood Ave, Sherwood, AR 72120-5074 | 2005-08-31 |
| 1497104715 | Derrick Evan Hall | Family Medicine | 16770 Sw Edy Rd Ste 102, Sherwood, OR 97140 | 2016-06-07 |
| 1114311222 | Sandra Iloka | Family Medicine | 16770 Sw Edy Rd Ste 102, Sherwood, OR 97140-9679 | 2015-03-26 |
| 1891015442 | Robyn Lashae Wilkerson | Family Medicine | 7709 Highway 107, Sherwood, AR 72120-4661 | 2010-06-06 |
| 1326233065 | Amy L Gerhard | Family Medicine | 16770 Sw Edy Rd, Sherwood, OR 97140-9678 | 2007-09-06 |
| 1285854844 | Patricia Eden Fernandez Millan | Family Medicine | 16770 Sw Edy Rd, Suite 102, Sherwood, OR 97140-9678 | 2007-04-26 |
| 1093835720 | Midwest Community Health Associates | Family Medicine | 9742 Us Highway 127, Sherwood, OH 43556-9739 | 2007-03-29 |
| Find all providers in SHERWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.