CHICOT MEMORIAL MEDICAL CENTER (NPI# 1568787059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568787059 |
| Entity Type | Organization |
| Organization Name | CHICOT MEMORIAL MEDICAL CENTER |
| 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 | 2010-03-29 |
| Last Update Date | 2016-11-04 |
| Authorized Official Name | SUSAN VAUGHN (CFO) |
| Authorized Official Telephone | 8702655351 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHICOT MEMORIAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | AR4650 | AR | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 181516514 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861901985 | Chicot Memorial Medical Center | Clinic/Center | 2729 S. Hwy 65 82, Lake Village, AR 71653 | 2017-09-20 |
| 1235453192 | Chicot Memorial Medical Center | General Acute Care Hospital | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-22 |
| 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 |
| 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 |
|---|---|---|---|---|
| 1235453192 | Chicot Memorial Medical Center | General Acute Care Hospital | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-22 |
| 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 |
| 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 | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013938893 | State of Arkansas | Home Health | 608 Highway 65 82 S, Chicot County Health Unit, Lake Village, AR 71653-1560 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528670130 | Home Health Care Agency of Arkansas, LLC | Home Health | 1200 John Barrow Road Suite #111, Little Rock, AR 72205-6528 | 2020-08-17 |
| 1316557127 | Voices of Healthcare | Home Health | 3700 S Caraway Rd Apt K07, Jonesboro, AR 72404-9537 | 2020-08-06 |
| 1093325334 | Clararose Home Care | Home Health | 802 Parrish St, Jacksonville, AR 72076-2720 | 2020-08-02 |
| 1447876024 | Jabez Community Resource Center | Home Health | 2910 Dickson St, West Memphis, AR 72301-3638 | 2020-06-19 |
| 1912521295 | Thrive Pediatric Nursing Inc | Home Health | 808 Reservoir Rd Ste A, Little Rock, AR 72227-5729 | 2020-06-03 |
| 1124651153 | Lareco Walker Sr. | Home Health | 1907 Hwy 5 N Apt 1010, Benton, AR 72019-6733 | 2020-02-18 |
| 1518500495 | Quality Senior Care, Inc. | Home Health | 17724 I 30 Ste 5, Benton, AR 72019-2961 | 2019-10-23 |
| 1659912376 | Diamond Personal Care, Ll | Home Health | 25 Macarthur Dr, Conway, AR 72032-4510 | 2019-10-03 |
| 1427607837 | Leyia Staffing Agency LLC | Home Health | 309 N 6th St Ste 3, West Memphis, AR 72301-3294 | 2019-09-09 |
| 1497317820 | 1 To 1 Home Care Services | Home Health | 1200 Westpark Dr Ste 202, Little Rock, AR 72204-2487 | 2019-07-06 |
| 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.