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MED79
NPI 1356117626
Family Medicine in Pine Bluff, AR

Active since November 28, 2023
2304 W 29TH AVE, PINE BLUFF, AR 71603(501) 804-5628 Get Directions Write a Review

NPPES record last updated: November 28, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Med79 NPPES

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

MED79 (NPI 1356117626) is a healthcare organization registered as a family medicine in Pine Bluff, Arkansas and active in the NPI registry since November 2023. The organization lists Christopher Keith Mcdaniel, Ceo, as its authorized official.

NPPES Registry Identity

NPI1356117626
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMED79
Location Address2304 W 29TH AVEPine Bluff, AR 71603-5005
Mailing Address3805 Winters PlPine Bluff, AR 71603-6413 · (501) 804-5628
Phone(501) 804-5628
Organization SubpartNo
Authorized OfficialChristopher Keith McdanielCeo · (501) 804-5628
Enumeration DateNovember 28, 2023
NPPES CertifiedNovember 28, 2023
✔ NPI 1356117626 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.
2304 W 29TH AVE, Pine Bluff, AR 71603
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES
Clinic/Center (Rehabilitation, Substance Use Disorder)
2304 W 29TH AVE
PINE BLUFF, AR 71603
Jefferson County (870) 247-5222
MR. SCOTT AARON MABRY CADC, CCS
Counselor (Addiction (Substance Use Disorder))
2304 W 29TH AVE
PINE BLUFF, AR 71603
Jefferson County (870) 247-5222
ROGER CAMERON ACADC, CCS
Counselor (Addiction (Substance Use Disorder))
2304 W 29TH AVE, SUITE 1
PINE BLUFF, AR 71603
Jefferson County (870) 247-5222
KAREN MARIE APPLEGET LPC
Counselor (Mental Health)
2304 W 29TH AVE
PINE BLUFF, AR 71603
Jefferson County (870) 247-5222
MADELINE NOEL FULTS CIT
Counselor (Addiction (Substance Use Disorder))
2304 W 29TH AVE, SUITE 1
PINE BLUFF, AR 71603
Jefferson County (870) 247-5222

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 Med79's NPI number?

The NPI number for Med79 is 1356117626. It was assigned to this organization in the NPPES registry on November 28, 2023.

Where is Med79 located?

Med79 is located at 2304 W 29th Ave, Pine Bluff, AR 71603. The listed phone number is (501) 804-5628.

What is Med79's specialty?

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

When was this NPI record last updated?

The NPPES record for Med79 was last updated on November 28, 2023. 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.