FAMILY MEDICAL CENTER
NPI 1528052107
Clinic/Center - Rural Health in Walnut Ridge, AR

Q: What is Lawrence Memorial Health Foundation Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since September 09, 2005CLIA 04D0691080 · Waiver

1309 W MAIN ST, WALNUT RIDGE, AR 72476(870) 886-3211(870) 886-9027 Get Directions Write a Review

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

Record update history: Jul 21, 2020, Mar 14, 2019 (2 updates tracked since 2019).

On this page

About Family Medical Center NPPES

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

FAMILY MEDICAL CENTER (NPI 1528052107) is a healthcare organization registered as a rural health in Walnut Ridge, Arkansas and active in the NPI registry since September 2005. The organization holds a CLIA Waiver certificate valid through February 11, 2028 and lists Vanessa K Wagner, Cfo, as its authorized official.

NPPES Registry Identity

NPI1528052107

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameLAWRENCE MEMORIAL HEALTH FOUNDATION INC.

Location Address1309 W MAIN STWalnut Ridge, AR 72476-1430

Mailing AddressPo Box 839Walnut Ridge, AR 72476-0839 · (870) 886-3211 · Fax (870) 886-9027

Phone(870) 886-3211

Fax(870) 886-9027

Organization SubpartNo

Authorized OfficialVanessa K WagnerCfo · (870) 886-1263

Enumeration DateSeptember 9, 2005

Last NPPES UpdateJuly 21, 20202 updates tracked since enumeration

NPPES CertifiedJuly 21, 2020

✔ NPI 1528052107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

1309 W MAIN ST, Walnut Ridge, AR 72476

Open in Google Maps ↗

Other Names 1

Doing Business AsFamily Medical Center

Other Identifiers 1

Medicaid234112729AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.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 04D0691080

Family Medical Center Lawrence Memorial Health Foundation, Inc · Walnut Ridge, AR

Active · expires Feb 11, 2028

CLIA Number04D0691080

Laboratory TypeRural Health Clinic

Certificate Effective DateFebruary 12, 2026

Certificate Expiration DateFebruary 11, 2028

Laboratory DirectorDr. Shannon S. Cooper

Laboratory Phone(870) 886-3211

Laboratory LocationFamily Medical Center Lawrence Memorial Health Foundation, Inc1309 West Main Street, Walnut Ridge, AR 72476

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

SHANNON SWIFT COOPER M.D.

Internal Medicine