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PRESTIGE CARE, PLLC
NPI 1255122602
Family Medicine in Blytheville, AR

Active since May 15, 2025CLIA 04D2327772 · Waiver
1100 MEDICAL DR STE C, BLYTHEVILLE, AR 72315(870) 472-8403(870) 472-8370 Get Directions Write a Review

NPPES record last updated: June 26, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 26, 2025, May 15, 2025 (2 updates tracked since 2025).

About Prestige Care, Pllc NPPES

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

PRESTIGE CARE, PLLC (NPI 1255122602), doing business as Prestige Care - Blytheville, is a healthcare organization registered as a family medicine in Blytheville, Arkansas and active in the NPI registry since May 2025. The organization holds a CLIA Waiver certificate valid through July 28, 2027 and lists Benjamin Wagner Carlyle, Owner, as its authorized official.

NPPES Registry Identity

NPI1255122602
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePRESTIGE CARE, PLLC
Location Address1100 MEDICAL DR STE CBlytheville, AR 72315-2437
Mailing AddressPo Box 9178Russellville, AR 72811-9178 · (800) 824-4094 · Fax (479) 968-1673
Phone(870) 472-8403
Fax(870) 472-8370
Organization SubpartNo
Authorized OfficialBenjamin Wagner CarlyleOwner · (479) 498-6700
Enumeration DateMay 15, 2025
Last NPPES UpdateJune 26, 20252 updates tracked since enumeration
NPPES CertifiedJune 26, 2025
✔ NPI 1255122602 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.

1100 MEDICAL DR STE C, Blytheville, AR 72315
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Other Names 1

Doing Business AsPrestige Care - Blytheville

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

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 04D2327772

Prestige Care · Paragould, AR
Active · expires Jul 28, 2027
CLIA Number04D2327772
Laboratory TypePhysician Office
Certificate Effective DateJuly 29, 2025
Certificate Expiration DateJuly 28, 2027
Laboratory DirectorDr. Benjamin Carlyle
Laboratory Phone(870) 472-8403
Laboratory LocationPrestige Care160 Greene 721 Rd Apt D, Paragould, AR 72450
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Prestige Care, PLLC's NPI number?

The NPI number for Prestige Care, PLLC is 1255122602. It was assigned to this organization in the NPPES registry on May 15, 2025. The provider is doing business as Prestige Care - Blytheville.

Where is Prestige Care, PLLC located?

Prestige Care, PLLC is located at 1100 Medical Dr Ste C, Blytheville, AR 72315. The listed phone number is (870) 472-8403.

What is Prestige Care, PLLC's specialty?

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

Does Prestige Care, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2327772) is associated with this NPI, valid through July 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Prestige Care, PLLC was last updated on June 26, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.