NPIMap

Organization Active NPI

Dardanelle Regional, LLC

Doing business as Dardanelle Regional Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Dardanelle, AR
National Provider Identifier
1023109097
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
AR3750 Issued in AR
Legal business name
DARDANELLE REGIONAL, LLC
Doing business as
Dardanelle Regional Medical Center
Practice address
200 North 3Rd Street
Dardanelle, AR 72834-0578
Phone
(479) 229-4677
NPI assigned
Sep 27, 2006
Last updated
Aug 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Alan Finley
Title
Ceo
Phone
(501) 450-2114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X AR3750 AR Primary

Addresses

Primary practice location

200 North 3Rd Street
Dardanelle, AR 72834-0578

Mailing address

PO Box 578
200 North 3Rd Street
Dardanelle, AR 72834-0578
Phone (479) 229-4677

Other names 1

  • Dardanelle Regional Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220523001905 AR Part A Provider - Critical Access Hospital 0345576500 Receives reassigned benefits from 13 practitioners
Practice locations: Dardanelle, AR
O20220525002921 AR Part A Provider - Critical Access Hospital 0345576500 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dardanelle, AR

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1023109097. Details of each certification follow.

Hospital certification: CCN 04Z302

Legal name
DARDANELLE REGIONAL LLC
Doing business as
DARDANELLE REGIONAL MEDICAL CENTER
Organization structure
LLCNon-profit
Incorporated
Apr 25, 2019 in AR
Enrollment address
200 N 3Rd St
Dardanelle, AR 72834-3802
Hospital Swing-Bed Unit

Hospital certification: CCN 04M302

Legal name
DARDANELLE REGIONAL LLC
Doing business as
DARDANELLE REGIONAL MEDICAL CENTER
Organization structure
LLCNon-profit
Incorporated
Apr 25, 2019 in AR
Enrollment address
200 N 3Rd Street
Dardanelle, AR 72834-3802
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dardanelle Regional LLC Organization, Dardanelle, AR LLC, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2022 100%
Conway Regional Medical Center Inc Organization, Conway, AR Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2022 100%
Alan Finley Individual Corporate DirectorCeo Jan 1, 2022 100%
W-2 Managing EmployeeCeo Jan 1, 2022
Corporate DirectorBoard Member Jan 1, 2022 100%
W-2 Managing EmployeeCeo Jan 1, 2022 100%
Operational/Managerial ControlChief Executive Officer Jun 1, 2019 100%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Dardanelle Regional Medical CenterDardanelle, AR, CCN 04M302 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2022
Dardanelle Regional Medical CenterDardanelle, AR, CCN 041302 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1023109097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 578",
            "address_2": "200 NORTH 3RD STREET",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728340578",
            "telephone_number": "479-229-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NORTH 3RD STREET",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728340578",
            "telephone_number": "479-229-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARDANELLE REGIONAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "FINLEY",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-450-2114",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "AR",
            "license": "AR3750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dardanelle Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dardanelle, AR

Sources for this page

Verify at the official NPI Registry.