HIGGINBOTHAM FAMILY CLINIC
NPI 1033129713
Family Medicine in Malvern, AR
About Higginbotham Family Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HIGGINBOTHAM FAMILY CLINIC (NPI 1033129713) is a healthcare organization registered as a family medicine in Malvern, Arkansas and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through July 21, 2027 and lists Kim Overton, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Higginbotham Family Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Higginbotham Family Clinic, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 04D2027363
Higginbotham Family Clinic · Rockport, ARFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shane Higginbotham MD PA's NPI number?
The NPI number for Shane Higginbotham MD PA is 1033129713. It was assigned to this organization in the NPPES registry on August 8, 2006. The provider is doing business as Higginbotham Family Clinic.
Where is Shane Higginbotham MD PA located?
Shane Higginbotham MD PA is located at 1002 Schneider Dr Suite 104, Malvern, AR 72104. The listed phone number is (501) 332-7981.
What is Shane Higginbotham MD PA's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Shane Higginbotham MD PA enrolled in Medicare?
Yes. Shane Higginbotham MD PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shane Higginbotham MD PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Shane Higginbotham MD PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5) and Family Practice (1). Of these, 2 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Shane Higginbotham MD PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D2027363) is associated with this NPI, valid through July 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Shane Higginbotham MD PA accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Shane Higginbotham MD PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Shane Higginbotham MD PA was last updated on May 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Higginbotham Family Clinic · NPI 1033129713
Family Medicine organization in Malvern, Arkansas. Organization record, active in the CMS NPPES registry since August 8, 2006.
## Identity
- **NPI:** 1033129713 (Entity type: Organization)
- **Enumerated:** August 8, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Shane Higginbotham Md Pa
- **Organization subpart:** No
- **Authorized official:** Kim Overton, OFFICE MANAGER
## Practice location
- **Address:** 1002 SCHNEIDER DR, SUITE 104, Malvern, AR 72104-4816
- **Phone:** (501) 332-7981 · **Fax:** (501) 337-9964
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Family Practice (1); 2 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 6, 2021
- **Other identifiers:** Medicaid 205795002 (AR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1033129713) · Data from the CMS NPPES public registry.