DE QUEEN FAMILY MEDICAL ASSOCIATES PLLC
NPI 1104678820
Family Medicine in De Queen, AR

Q: What is De Queen Family Medical Associates PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since April 04, 2024

500 E COLLIN RAYE DR, DE QUEEN, AR 71832(870) 584-3627 Get Directions Write a Review

NPPES record last updated: May 31, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Apr 25, 2024, Apr 10, 2024, Apr 4, 2024 (3 updates tracked since 2024).

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About De Queen Family Medical Associates Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DE QUEEN FAMILY MEDICAL ASSOCIATES PLLC (NPI 1104678820) is a healthcare organization registered as a family medicine in De Queen, Arkansas and active in the NPI registry since April 2024. The organization lists William H. Kelley, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1104678820

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameDE QUEEN FAMILY MEDICAL ASSOCIATES PLLC

Location Address500 E COLLIN RAYE DRDe Queen, AR 71832-8048

Mailing Address500 E Collin Raye DrDe Queen, AR 71832-8048

Phone(870) 584-3627

Organization SubpartNo

Authorized OfficialWilliam H. KelleyAuthorized Official · (870) 584-3627

Enumeration DateApril 4, 2024

Last NPPES UpdateMay 31, 20243 updates tracked since enumeration

NPPES CertifiedMay 31, 2024

✔ NPI 1104678820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

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.

500 E COLLIN RAYE DR, De Queen, AR 71832

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Other Identifiers 1

Medicaid319492002AR

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

De Queen Family Medical Associates Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to De Queen Family Medical Associates PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Lindsey Gillihan, APRN, FNP-C

Nurse Practitioner

NPI 1033062492

500 E COLLIN RAYE DR
De Queen, AR 71832

(870) 584-3627

✔ PECOS✔ Accepts MedicareSame address

Shantae Rankin, APRN

Nurse Practitioner

NPI 1588396857

203 W DEQUEEN AVE
De Queen, AR 71832

(870) 642-4000

✔ PECOS✔ Accepts Medicare0.6 mi

William Kelley, M.D.

Family Practice

NPI 1376561647

7069 US HIGHWAY 67 E
Maud, TX 75567

(903) 244-4850

✔ PECOS✔ Accepts Medicare48 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently 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 De Queen Family Medical Associates PLLC's NPI number?

The NPI number for De Queen Family Medical Associates PLLC is 1104678820. It was assigned to this organization in the NPPES registry on April 4, 2024.

Where is De Queen Family Medical Associates PLLC located?

De Queen Family Medical Associates PLLC is located at 500 E Collin Raye Dr, De Queen, AR 71832. The listed phone number is (870) 584-3627.

What is De Queen Family Medical Associates PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is De Queen Family Medical Associates PLLC enrolled in Medicare?

Yes. De Queen Family Medical Associates PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through De Queen Family Medical Associates PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to De Queen Family Medical Associates PLLC, in Family Practice and Nurse Practitioner. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for De Queen Family Medical Associates PLLC was last updated on May 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.