NPIMap

Organization Active NPI

Magnolia Regional Health System Inc

  • Family Medicine Physician
  • Magnolia, AR
National Provider Identifier
1023778115
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MAGNOLIA REGIONAL HEALTH SYSTEM INC
Practice address
104 E Columbia
Magnolia, AR 71753-2436
Phone
(870) 235-3550
NPI assigned
Dec 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Mr. William D Giles
Title
Chief Executive Officer
Phone
(870) 235-3208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

104 E Columbia
Magnolia, AR 71753-2436

Mailing address

PO Box 629
Magnolia, AR 71754-0629
Phone (870) 235-3550

Other names 1

  • Magnolia Primary Care Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200924002030 AR Part B Supplier - Clinic/Group Practice 2668899899 Receives reassigned benefits from 7 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Magnolia, AR

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Regional HLTH Syst5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1005 N Jackson
Ste C
Magnolia, AR 71753
Phone (870) 235-3550

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1023778115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717540629",
            "telephone_number": "870-235-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E COLUMBIA",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532436",
            "telephone_number": "870-235-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA REGIONAL HEALTH SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-30",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "GILES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "870-235-3208",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Primary Care Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Magnolia Primary Care Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Magnolia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.