DECLERK FAMILY MEDICINE, PLLC
NPI 1366354938
Family Medicine in Rogers, AR
About Declerk Family Medicine, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DECLERK FAMILY MEDICINE, PLLC (NPI 1366354938) is a healthcare organization registered as a family medicine in Rogers, Arkansas and active in the NPI registry since September 2026. The organization holds a CLIA Waiver certificate valid through October 11, 2028 and lists George Ryan Declerk, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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 04D2352219
Declerk Family Medicine · Rogers, AROther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Declerk Family Medicine, PLLC's NPI number?
The NPI number for Declerk Family Medicine, PLLC is 1366354938. It was assigned to this organization in the NPPES registry on September 18, 2026.
Where is Declerk Family Medicine, PLLC located?
Declerk Family Medicine, PLLC is located at 4305 S Pleasant Crossing Blvd Ste 103, Rogers, AR 72758. The listed phone number is (479) 302-1020.
What is Declerk Family Medicine, PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Does Declerk Family Medicine, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D2352219) is associated with this NPI, valid through October 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Declerk Family Medicine, PLLC was last updated on September 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 51 days 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.
# Declerk Family Medicine, Pllc · NPI 1366354938
Family Medicine organization in Rogers, Arkansas. Organization record, active in the CMS NPPES registry since September 18, 2026.
## Identity
- **NPI:** 1366354938 (Entity type: Organization)
- **Enumerated:** September 18, 2026
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** George Declerk, MANAGER
## Practice location
- **Address:** 4305 S PLEASANT CROSSING BLVD STE 103, Rogers, AR 72758-1347
- **Phone:** (479) 302-1020
## Record status
- **NPPES last updated:** September 18, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1366354938) · Data from the CMS NPPES public registry.