NPIMap

Organization Active NPI

Access Medical Clinic LLC

Doing business as Access Medical Clinic

  • Rural Health Clinic/Center
  • Gatlinburg, TN
National Provider Identifier
1023621646
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ACCESS MEDICAL CLINIC LLC
Doing business as
Access Medical Clinic
Practice address
204 Glades Rd
Gatlinburg, TN 37738-5601
Phone
(865) 436-2811
Fax
(833) 989-2491
NPI assigned
Aug 24, 2020
Last updated
Jan 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Authorized official

Name
Monya York
Title
Controller
Phone
(870) 856-1202

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

204 Glades Rd
Gatlinburg, TN 37738-5601

Mailing address

4196 Highway 62 412 Ste a
Hardy, AR 72542-8002
Phone (870) 856-1202

Other names 1

  • Access Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201015001357 TN Part B Supplier - Clinic/Group Practice 1951721802 Receives reassigned benefits from 10 practitioners
4 other NPIs on this enrollment
Practice locations: Clinton, TN; Crossville, TN; Gatlinburg, TN; Jacksboro, TN
O20201201000846 TN Part A Provider - Rural Health Clinic 1951721802 Practice locations: Gatlinburg, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023621646. Details of each certification follow.

Rural health clinic certification: CCN 883841

Legal name
ACCESS MEDICAL CLINIC LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 26, 2021
Last certification
Apr 26, 2021
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Jun 12, 2020 in TN
Enrollment address
204 Glades Rd
Gatlinburg, TN 37738-5601

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2191694Access Medical Clinic Tennessee LLC204 Glades Road, Gatlinburg, TN 37738Certificate of waiverAug 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Access Medical Clinic11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1641 S US Highway 231
Crawfordsvlle, IN 47933
Phone (765) 307-7146

13 Bob Tollett Loop
Crossville, TN 38555
Phone (931) 456-6057

2702 Jacksboro Pike
Jacksboro, TN 37757
Phone (423) 201-9937

1700 W FM 700
Ste B
Big Spring, TX 79720
Phone (432) 264-1900

1819 Jay Ell Dr
Richardson, TX 75081
Phone (469) 474-9575

Networks

  • devoted network organization-5b6e8479-727f-40cf-ba4e-9b59e43aa45e

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Howard Freeman Individual Corporate DirectorSVP of Clinic Division May 19, 2026
W-2 Managing EmployeeAd; May 19, 2026
Operational/Managerial ControlSVP of Clinic Division May 19, 2026
Mark Hahn Individual 5% Or Greater Direct Ownership InterestCeo May 8, 2025 100%
Corporate OfficerMedical Director May 8, 2025
Tony D James Individual Corporate OfficerCfo May 19, 2026
W-2 Managing EmployeeAd; May 19, 2026
Jared Clifford Individual Corporate OfficerCeo May 8, 2025
W-2 Managing EmployeeAd; May 19, 2026
Monya York Individual Corporate DirectorDirector Credentialing May 8, 2025
W-2 Managing EmployeeDirector Credentialing Jun 12, 2020
Randi L Davis Individual Corporate DirectorSr Director Clinic Operations May 19, 2026
W-2 Managing EmployeeAd; May 8, 2025
Operational/Managerial ControlSr Director Clinic Operations May 19, 2026
Kasey Crawford Individual Corporate DirectorDirector Clinic Operation May 19, 2026
W-2 Managing Employee May 19, 2026

Owners & managing parties with NPI records 2

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

  • Randi L Davis, APRN
    • Family Nurse Practitioner
    • Bay, AR
    • NPI 1740622497

    Corporate Director, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership
  • Mark S Hahn, DO
    • Family Medicine Physician
    • Caraway, AR
    • NPI 1609895911

    5% Or Greater Direct Ownership Interest, Corporate Officer

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1023621646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4196 HIGHWAY 62 412 STE A",
            "city": "HARDY",
            "state": "AR",
            "postal_code": "725428002",
            "telephone_number": "870-856-1202",
            "fax_number": "870-856-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 GLADES RD",
            "city": "GATLINBURG",
            "state": "TN",
            "postal_code": "377385601",
            "telephone_number": "865-436-2811",
            "fax_number": "833-989-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-24",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "YORK",
        "authorized_official_first_name": "MONYA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "870-856-1202"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Access Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Access Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gatlinburg, TN

Sources for this page

Verify at the official NPI Registry.