MAINLINE HEALTH SYSTEMS INC (NPI# 1316106388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316106388 |
| Entity Type | Organization |
| Organization Name | MAINLINE HEALTH SYSTEMS INC |
| Other Organization Name | PORTLAND HEALTH CARE |
| Practice Address |
233 N Main St Portland AR 71663 |
| Mailing Address |
Po Box 100 233 N Main St Portland AR 71663-0100 |
| Practice Telephone | 8707372221 |
| Practice Fax Number | 8558785991 |
| Mailing Telephone | 8707372737 |
| Mailing Fax Number | 8707379780 |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2018-09-14 |
| Authorized Official Name | GARY ALLAN NICHOLS (CFO) |
| Authorized Official Telephone | 8705385414 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 117615749 | 05 |
| Other Name | Type Code |
|---|---|
| PORTLAND HEALTH CARE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396383758 | Mainline Health Systems Inc | Clinic/Center | 1012 E Church St Ste B, Warren, AR 71671-3530 | 2019-12-17 |
| 1205163540 | Mainline Health Systems Inc | Clinic/Center | 535 Jordan Dr, Monticello, AR 71655-5714 | 2009-11-06 |
| 1386758043 | Mainline Health Systems Inc | Clinic/Center | 300 S School St, Dermott, AR 71638-2228 | 2006-08-19 |
| 1891809547 | Mainline Health Systems Inc | Clinic/Center | 203 Mccomb St, Wilmot, AR 71676 | 2006-08-19 |
| Street Address |
233 N MAIN ST |
| City | PORTLAND |
| State | AR |
| Zip Code | 71663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982128096 | Myra Brooke Flemister | Nurse Practitioner | 233 N Main St, Portland, AR 71663-9230 | 2017-07-31 |
| 1376841247 | Byron K Montgomery | Nurse Practitioner | 233 N Main St, Portland, AR 71663-9230 | 2011-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396074886 | Amy Floyd | Social Worker | 233 North Main, Portland, AR 71663 | 2009-12-14 |
| 1891942975 | Jeannie Rebecca Tucker | Counselor | 233 N Main, Portland, AR 71663 | 2008-08-20 |
| 1578770582 | Portland Drug Inc. | Pharmacy | 105 Hwy 165 South, Portland, AR 71663 | 2007-05-17 |
| 1942611504 | Portland Drug LLC | Pharmacy | 105 Hwy 65 South, Portland, AR 71663-0000 | 2014-05-16 |
| 1649636986 | Mainline Health Systems, Inc | Clinic/Center | 314 Highway 160 E, Portland, AR 71663-9262 | 2015-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013712 | Gabriel Henriques | Massage Therapist | 805 Se Peacock Ln, Portland, OR 97214-3278 | 2020-11-07 |
| 1669073490 | Krista Marie Obenlock | Acupuncturist | 2408 N Baldwin St, Portland, OR 97217-6404 | 2020-11-06 |
| 1265033088 | Palms Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1500 Forest Ave Apt 13d, Portland, ME 04103-1846 | 2020-11-06 |
| 1104427160 | Kristine Lee Jones | Counselor | 2628 Se 87th Ave, Portland, OR 97266-1530 | 2020-11-05 |
| 1356942221 | Joseph Cody Brainard | Physical Therapist | 4416 Ne Simpson St, Portland, OR 97218-1446 | 2020-11-05 |
| 1427659671 | Lindsay Marie Thomas | Doula | 4503 Se 66th Ave, Portland, OR 97206-4501 | 2020-11-04 |
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1063013373 | Ruth Tessema | Counselor | 2120 Ne 166th Dr, Portland, OR 97230-5558 | 2020-11-03 |
| 1598366064 | Felipe Gregorio Flores | Dentist | 107 Shorecliff Dr, Portland, TX 78374-1459 | 2020-11-02 |
| 1982204509 | Uchendu Ezra Iwuanyanwu | Occupational Therapy Assistant | 3550 S Bond Ave, Portland, OR 97239-4507 | 2020-11-01 |
| Find all providers in PORTLAND | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679047872 | Portland Community Health Center | Clinic/Center | 52 Frederic St, Portland, ME 04102-2700 | 2019-01-22 |
| 1043783822 | Portland Community Health Center | Clinic/Center | 72 Bishop St, Portland, ME 04102-2957 | 2019-01-04 |
| 1770056558 | Portland Community Health Center | Clinic/Center | 190 Valley Street, Portland, ME 04102-2957 | 2019-01-04 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1700317971 | Portland Community Health Center | Clinic/Center | 28 Portland St, Portland, ME 04101-2912 | 2017-03-21 |
| 1255872537 | Portland Community Health Center | Clinic/Center | 175 Auburn St, Portland, ME 04103-2131 | 2017-03-20 |
| 1477005619 | Outside In | Clinic/Center | 1226 Sw 12th Ave, Portland, OR 97205-2029 | 2016-11-03 |
| 1649636986 | Mainline Health Systems, Inc | Clinic/Center | 314 Highway 160 E, Portland, AR 71663-9262 | 2015-12-31 |
| 1144691098 | Central City Concern Inc | Clinic/Center | 2566 Ne Hoyt St, Portland, OR 97232-2323 | 2015-10-16 |
| 1295119386 | Central City Concern Inc | Clinic/Center | 12133 E. Burnside St, Portland, OR 97216-2344 | 2015-07-17 |
| Find all providers in PORTLAND | ||||
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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.