MAINLINE HEALTH SYSTEMS INC (NPI# 1386758043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386758043 |
| Entity Type | Organization |
| Organization Name | MAINLINE HEALTH SYSTEMS INC |
| Other Organization Name | MAINLINE DERMOTT MEDICAL CLINC |
| Practice Address |
300 S School St Dermott AR 71638-2228 |
| Mailing Address |
Po Box 100 Portland AR 71663-0100 |
| Practice Telephone | 8705385296 |
| Practice Fax Number | 8705383701 |
| Mailing Telephone | 8707372737 |
| Mailing Fax Number | 8707379780 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2008-05-22 |
| Authorized Official Name | MARY A SCOTT (CFO) |
| Authorized Official Telephone | 8707372737 |
| Is Organization Subpart | Y |
| Parent Organization Name | MAINLINE HEALTH SYSTEMS, INC. |
| 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 | 122645749 | 05 |
| Other Name | Type Code |
|---|---|
| MAINLINE DERMOTT MEDICAL CLINC | 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 |
| 1316106388 | Mainline Health Systems Inc | Clinic/Center | 233 N Main St, Portland, AR 71663 | 2008-06-05 |
| 1891809547 | Mainline Health Systems Inc | Clinic/Center | 203 Mccomb St, Wilmot, AR 71676 | 2006-08-19 |
| Street Address |
300 S SCHOOL ST |
| City | DERMOTT |
| State | AR |
| Zip Code | 71638-2228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962044800 | Charlie J Gober | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2019-10-11 |
| 1710448535 | Clark N Roberts | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2019-03-26 |
| 1205315637 | Kimberly Weeks | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2018-08-07 |
| 1184102303 | William Joshua Hunter | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2018-07-31 |
| 1104361880 | Tiffany Wargo | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2017-01-04 |
| 1386026359 | Courtney Shay Johnson | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2015-06-25 |
| 1669886552 | Shenika Jackson-king | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2014-06-18 |
| 1821409996 | Crystal Little | Pediatrics | 300 S School St, Dermott, AR 71638-2127 | 2014-05-12 |
| 1659710879 | Dana Shea Phillips | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2013-06-20 |
| 1003021692 | Gary Dalton | Dentist | 300 S School St, Dermott, AR 71638-2127 | 2007-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104251180 | Rebekah Ayecock | Nurse Practitioner | 300 South School St, Dermott, AR 71638 | 2013-09-09 |
| 1508198201 | Roger Alan Mason | Surgery | 300 South School St., Dermott, AR 71638 | 2010-02-04 |
| 1730219353 | Dermott Day Service Center, Inc. | Day Training, Developmentally Disabled Services | 817 North School Street, Dermott, AR 71638 | 2007-03-06 |
| 1134286750 | Dermott City Nursing Home | Skilled Nursing Facility | 702 West Gaines St., Dermott, AR 71638 | 2007-01-02 |
| 1861555005 | Dermott High School | Local Education Agency (LEA) | 525 East Speedway, Dermott, AR 71638 | 2006-12-19 |
| 1811095656 | Phillip W Pennington | Dentist | 300 S School, Dermott, AR 71638 | 2006-09-20 |
| 1669401501 | Mainline Health Systems, Inc | Clinic/Center | 134 South Strickland St, Dermott, AR 71638 | 2006-07-02 |
| 1982643409 | Jeffery Fenton Dunn Sr. | Pharmacist | 111 E Peddicord Street, Dermott, AR 71638 | 2006-06-06 |
| 1609298306 | Cb King Jm | Day Training, Developmentally Disabled Services | 1109 North School, Dermott, AR 71638-0000 | 2014-01-15 |
| 1780119610 | Medical Transport Management, Inc | Ambulance | 109 W Peddicord St, Dermott, AR 71638-2115 | 2017-04-28 |
| Find all providers in zip 71638 | ||||
| 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 |
|---|---|---|---|---|
| 1669401501 | Mainline Health Systems, Inc | Clinic/Center | 134 South Strickland St, Dermott, AR 71638 | 2006-07-02 |
| 1477004471 | Mainline Health Systems, Inc | Clinic/Center | 525 E Speedway St, Dermott, AR 71638-2322 | 2016-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962014316 | Healthy Connections, Inc. | Clinic/Center | 1306 W Collin Raye Dr Ste B, De Queen, AR 71832-2502 | 2020-08-18 |
| 1982221065 | Arcare | Clinic/Center | 7300 Dollarway Rd Ste 116, White Hall, AR 71602-3023 | 2020-07-06 |
| 1669099073 | St Francis House Nwa, Inc | Clinic/Center | 1923 W Pickens Road, Pea Ridge, AR 72751 | 2020-07-01 |
| 1427674696 | Arcare | Clinic/Center | 11520 Sr 27, Hector, AR 72843-8710 | 2020-06-23 |
| 1487280384 | Arcare | Clinic/Center | 2805 Mid Cities Dr Ste 1, Bentonville, AR 72712-4291 | 2020-03-23 |
| 1073144028 | Arcare | Clinic/Center | 145 N Curtis Ave, Pea Ridge, AR 72751-3407 | 2020-01-29 |
| 1396383758 | Mainline Health Systems Inc | Clinic/Center | 1012 E Church St Ste B, Warren, AR 71671-3530 | 2019-12-17 |
| 1275177883 | Boston Mountain Rural Health Center, Inc | Clinic/Center | 1201 North Panther Ave # 3, Yellville, AR 72687 | 2019-11-06 |
| 1649814138 | St Francis House Nwa, Inc | Clinic/Center | 2328 Cardinal Drive, Springdale, AR 72764-4469 | 2019-10-29 |
| 1104469832 | Arcare | Clinic/Center | 501 Millwood Cir Ste E, Maumelle, AR 72113-6304 | 2019-10-25 |
| Find all providers with the same taxonomy | ||||
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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.