Cardinal Care Clinic, LLC
Organization Active NPI Primary Care Clinic/Center · Ashdown, AR
NPI 1023838539 · NPPES record last updated Oct 10, 2024
Key facts
- NPI
- 1023838539
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- CARDINAL CARE CLINIC, LLC
- Practice address
- 1340 S Constitution Ave
Ashdown, AR 71822-8652 - Phone
- (870) 888-2748
- Fax
- (870) 659-2273
- NPI assigned
- Oct 10, 2024
- Organization subpart
- No
Authorized official
- Name
- Ms. Brittny Nicole Mills, NP
- Title
- Agpncp-C/Owner
- Phone
- (870) 888-2748
Practitioners 1
-
Brittny Nicole Mills, AGPCNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D2313318 | Cardinal Care Clinic | Certificate of waiver | Oct 28, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241114004292 | AR | Part B Supplier - Clinic/Group Practice | 9436683240 |
Receives reassigned benefits from 1 practitioner Practice locations: Ashdown, AR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
1340 S Constitution Ave
Ashdown, AR 71822-8652
Mailing address
1340 S Constitution Ave
Ashdown, AR 71822-8652
Phone (870) 888-2748
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All providers in Ashdown, AR · Primary Care Clinic/Center in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.