PRIMARY CARE 360
NPI 1124678586
Family Medicine in Sherwood, AR

Active since September 18, 2019CLIA 04D2194560 · Waiver
100 SHADOW OAKS DR, SHERWOOD, AR 72120(501) 486-4045 Get Directions Write a Review

NPPES record last updated: October 21, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 21, 2020, Aug 18, 2020, Jul 24, 2020 and 2 more (5 updates tracked since 2019).

About Primary Care 360 NPPES

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

PRIMARY CARE 360 (NPI 1124678586) is a healthcare organization registered as a family medicine in Sherwood, Arkansas and active in the NPI registry since September 2019. The organization holds a CLIA Waiver certificate valid through September 30, 2026, maintains 2 additional practice locations, and lists Khalid Rayaz, Owner, as its authorized official.

NPPES Registry Identity

NPI1124678586
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePRIMARY CARE 360
Location Address100 SHADOW OAKS DRSherwood, AR 72120-6046
Mailing Address100 Shadow Oaks DrSherwood, AR 72120-6046 · (501) 486-4045 · Fax (888) 213-5007
Organization SubpartNo
Authorized OfficialKhalid RayazOwner · (501) 833-4001
Enumeration DateSeptember 18, 2019
Last NPPES UpdateOctober 21, 20205 updates tracked since enumeration
NPPES CertifiedOctober 21, 2020
NPI 1124678586 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.
100 SHADOW OAKS DR, Sherwood, AR 72120

Secondary Practice Locations 2

Location 1300 S Shackleford RdLittle Rock, AR 72211-5725 · Phone (501) 918-9192 · Fax (501) 295-7679
Location 2103 Frankie LnWhite Hall, AR 71602-2685 · Phone (870) 393-5050

Other Identifiers 1

OtherE-4732AR · State License

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

Accepted Insurance

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 04D2194560

Primary Care 360 - Sherwood · Sherwood, AR
Active · expires Sep 30, 2026
CLIA Number04D2194560
Laboratory TypePhysician Office
Certificate Effective DateOctober 1, 2024
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorDr. Khalid Rayaz
Laboratory Phone(501) 833-4001
Laboratory LocationPrimary Care 360 - Sherwood100 Shadow Oak Drive, Sherwood, AR 72120
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Urgent Care)
100 SHADOW OAKS DR
SHERWOOD, AR 72120
Internal Medicine
100 SHADOW OAKS DR
SHERWOOD, AR 72120
Internal Medicine
100 SHADOW OAKS DR
SHERWOOD, AR 72120
Internal Medicine
100 SHADOW OAKS DR
SHERWOOD, AR 72120
Clinic/Center (Adult Day Care)
100 SHADOW OAKS DR
SHERWOOD, AR 72120
Clinical Medical Laboratory
100 SHADOW OAKS DR
SHERWOOD, AR 72120
Psychiatry & Neurology (Clinical Neurophysiology)
100 SHADOW OAKS DR
SHERWOOD, AR 72120

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 Primary Care 360's NPI number?

The NPI number for Primary Care 360 is 1124678586. It was assigned to this organization in the NPPES registry on September 18, 2019.

Where is Primary Care 360 located?

Primary Care 360 is located at 100 Shadow Oaks Dr, Sherwood, AR 72120. The listed phone number is (501) 486-4045.

What is Primary Care 360's specialty?

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

Does Primary Care 360 hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2194560) is associated with this NPI, valid through September 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Primary Care 360 accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Primary Care 360 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 Primary Care 360 was last updated on October 21, 2020. 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.