CHICOT MEMORIAL MEDICAL CENTER (NPI# 1235453192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235453192 |
| Entity Type | Organization |
| Organization Name | CHICOT MEMORIAL MEDICAL CENTER |
| Other Organization Name | CHICOT MEMORIAL MEDICAL CENTER WOMEN'S CLINIC |
| Practice Address |
2729 Hwy 65 & 82 S Lake Village AR 71653-6136 |
| Practice Telephone | 8702655351 |
| Practice Fax Number | 8702652091 |
| Mailing Telephone | 8702655351 |
| Mailing Fax Number | 8702652091 |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2015-07-09 |
| Authorized Official Name | SUSAN VAUGHN (CFO) |
| Authorized Official Telephone | 8702655351 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
AR4386 | AR | Hospitals |
| N | 341600000X | Ambulance | Transportation Services | ||
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 181080105 | 05 | |
| AR | 195528715 | 05 |
| Other Name | Type Code |
|---|---|
| Chicot Memorial Medical center Women's Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861901985 | Chicot Memorial Medical Center | Clinic/Center | 2729 S. Hwy 65 82, Lake Village, AR 71653 | 2017-09-20 |
| 1003213281 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-12-03 |
| 1841602810 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-05-27 |
| 1104238179 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-05-27 |
| 1568787059 | Chicot Memorial Medical Center | Home Health | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| 1902121494 | Chicot Memorial Medical Center | Emergency Medicine | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| 1457676942 | Chicot Memorial Medical Center | Nurse Anesthetist, Certified Registered | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| 1821313313 | Chicot Memorial Medical Center | Medicare Defined Swing Bed Unit | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| Street Address |
2729 HWY 65 & 82 S |
| City | LAKE VILLAGE |
| State | AR |
| Zip Code | 71653-6136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003213281 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-12-03 |
| 1841602810 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-05-27 |
| 1104238179 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-05-27 |
| 1568787059 | Chicot Memorial Medical Center | Home Health | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| 1902121494 | Chicot Memorial Medical Center | Emergency Medicine | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| 1457676942 | Chicot Memorial Medical Center | Nurse Anesthetist, Certified Registered | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| 1821313313 | Chicot Memorial Medical Center | Medicare Defined Swing Bed Unit | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811500192 | Ashley Brown | Speech-Language Pathologist | 336 Us-82, Lake Village, AR 71653 | 2020-08-26 |
| 1861901985 | Chicot Memorial Medical Center | Clinic/Center | 2729 S. Hwy 65 82, Lake Village, AR 71653 | 2017-09-20 |
| 1326586173 | Mainline Health Systems, Inc | Clinic/Center | 360 A Hwy 82, Lake Village, AR 71653 | 2017-02-01 |
| 1508303124 | Mainline Health Systems, Inc | Clinic/Center | 360 A Highway 82, Lake Village, AR 71653 | 2017-01-20 |
| 1689120263 | Russell Medical Services Pllc | Family Medicine | 5071 Highway 82 E, Lake Village, AR 71653 | 2016-09-01 |
| 1528362035 | Hillman Chiropractic LLC | Chiropractor | 2819 Louis Sessions Dr., Lake Village, AR 71653 | 2010-12-28 |
| 1902113913 | Sheri K Bagwell | Counselor | 1127 Second St., Lake Village, AR 71653 | 2010-09-13 |
| 1205154044 | Arkansas Department of Health | Public Health or Welfare | 1742 Hwy 65 and 82 South, Lake Village, AR 71653 | 2010-05-04 |
| 1114259041 | William Jackson Weaver | General Practice | 1754 Lake Hall Road, Lake Village, AR 71653 | 2010-02-03 |
| 1821246992 | Maurenella Antionette Nelson | Social Worker | 1127 Second Street, Lake Village, AR 71653 | 2008-09-03 |
| Find all providers in zip 71653 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063571107 | Chicot Memorial Hospital | General Acute Care Hospital | 2729 Hwy 65 and 82 South, Lake Village, AR 71653 | 2006-12-06 |
| 1497701973 | Chicot Memorial Hospital | General Acute Care Hospital | 2729 Hwy 65 & 82 South, Lake Village, AR 71653 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265448468 | Cavhs | General Acute Care Hospital | 2307 Red Bud Cv, Benton, AR 72015-4779 | 2006-07-31 |
| 1013941806 | Booneville Community Hospital | General Acute Care Hospital | 880 W. Main St., Booneville, AR 72927 | 2006-07-10 |
| 1295767689 | Delta Memorial Hospital | General Acute Care Hospital | 811 Hwy 65 South, Dumas, AR 71639 | 2006-07-07 |
| 1457306326 | Mercy Hospital Berryville | General Acute Care Hospital | 214 Carter St, Berryville, AR 72616-4303 | 2006-05-22 |
| 1417913419 | White River Health System, Inc. | General Acute Care Hospital | 2106 E Main St, Mountain View, AR 72560-6439 | 2006-04-26 |
| 1912978875 | Mercy Hospital Waldron | General Acute Care Hospital | 1341 W 6th St, Waldron, AR 72958-7642 | 2006-01-30 |
| 1275504128 | Mercy Hospital Ozark | General Acute Care Hospital | 801 W River St, Ozark, AR 72949-3023 | 2006-01-30 |
| 1760453633 | Mercy Hospital Paris | General Acute Care Hospital | 500 E Academy St, Paris, AR 72855-4040 | 2006-01-30 |
| 1306826029 | Board of Governors of Dallas County Medical Center | General Acute Care Hospital | 201 North Clifton Street, Fordyce, AR 71742 | 2006-01-19 |
| 1972586238 | Dewitt Hospital & Nursing Home, Inc. | General Acute Care Hospital | 1641 S Whitehead Dr, De Witt, AR 72042-2994 | 2005-11-21 |
| Find all providers with the same taxonomy | ||||
| City | LAKE VILLAGE |
| Zip Code | 71653 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.