DELTA FAMILY CLINIC
NPI 1942915517
Nurse Practitioner - Family in Forrest City, AR
About Delta Family Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DELTA FAMILY CLINIC (NPI 1942915517) is a healthcare organization registered as a family in Forrest City, Arkansas and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through January 19, 2027 and lists Samantha Devazier, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Delta Family Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Delta Family Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 04D2275410
Delta Family Clinic · Forrest City, ARFrequently 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 Samantha Devazier Aprn PLLC's NPI number?
The NPI number for Samantha Devazier Aprn PLLC is 1942915517. It was assigned to this organization in the NPPES registry on January 18, 2023. The provider is doing business as Delta Family Clinic.
Where is Samantha Devazier Aprn PLLC located?
Samantha Devazier Aprn PLLC is located at 1111 N Washington St, Forrest City, AR 72335. The listed phone number is (870) 594-8012.
What is Samantha Devazier Aprn PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Samantha Devazier Aprn PLLC enrolled in Medicare?
Yes. Samantha Devazier Aprn PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Samantha Devazier Aprn PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Samantha Devazier Aprn PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Samantha Devazier Aprn PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D2275410) is associated with this NPI, valid through January 19, 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 Samantha Devazier Aprn PLLC was last updated on May 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Delta Family Clinic · NPI 1942915517
Family organization in Forrest City, Arkansas. Organization record, active in the CMS NPPES registry since January 18, 2023.
## Identity
- **NPI:** 1942915517 (Entity type: Organization)
- **Enumerated:** January 18, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Legal business name:** Samantha Devazier Aprn Pllc
- **Organization subpart:** No
- **Authorized official:** Samantha Devazier, OWNER
## Practice location
- **Address:** 1111 N WASHINGTON ST, Forrest City, AR 72335-2150
- **Phone:** (870) 594-8012 · **Fax:** (870) 594-8013
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 1, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1942915517) · Data from the CMS NPPES public registry.