NPIMap

Organization Active NPI

Phillips Clinic Company, LLC

Doing business as Marianna Medical Clinic

  • Rural Health Clinic/Center
  • Marianna, AR
National Provider Identifier
1033999396
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PHILLIPS CLINIC COMPANY, LLC
Doing business as
Marianna Medical Clinic
Practice address
15 N Poplar St
Marianna, AR 72360-2318
Phone
(870) 295-3430
NPI assigned
Oct 4, 2023
Last updated
Jun 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Authorized official

Name
William Taylor Marshall
Title
Attorney
Phone
(501) 786-4007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

15 N Poplar St
Marianna, AR 72360-2318

Mailing address

265 North Lamar Blvd
Suite C
Oxford, MS 38655-3710
Phone (870) 338-5800

Other names 1

  • Marianna Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240122000251 AR Part A Provider - Rural Health Clinic 3870576259 Practice locations: Marianna, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033999396. Details of each certification follow.

Rural health clinic certification: CCN 043941

Legal name
PHILLIPS CLINIC COMPANY, LLC
Doing business as
MARIANNA MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 24, 2024
Last certification
May 24, 2024
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Jul 1, 2003 in AR
Enrollment address
15 N Poplar St
Marianna, AR 72360-2318

Other NPIs with the same Medicare PAC ID 2

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

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
04D2084745Marianna Medical Clinic15 North Poplar St, Marianna, AR 72360Certificate of waiverMay 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Helena Medical Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

109 Professional Plz
Helena, AR 72342
Phone (870) 572-6720

109B Professional Plz
Helena, AR 72342
Phone (870) 228-1480

1801 Martin Luther King Jr Dr
#2
Helena, AR 72342
Phone (870) 816-3917

1801 Martin Luther King Jr Dr
Ste A
Helena, AR 72342
Phone (870) 816-3400

810A Newman Dr
Helena, AR 72342
Phone (870) 338-7411

15 N Poplar St
Marianna, AR 72360
Phone (870) 295-3430

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Ed Pat Wright Individual Corporate OfficerPresident Jun 1, 2025 20%
Corporate Director Jun 1, 2025 20%
Operational/Managerial ControlPresident Jun 1, 2025 20%
Dexter Miller Individual Corporate Director Jun 1, 2025 20%
Melody Rogers Individual Corporate Director Jun 1, 2025
Kevin Smith Individual Corporate Director Jun 1, 2025 20%
Helena Heath Foundation Organization, Helena, AR Non-profit 5% Or Greater Direct Ownership Interest Jun 1, 2025 100%
Operational/Managerial Control Jun 1, 2025 100%
Shanna Pryor Individual Corporate Director Jun 1, 2025

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1033999396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 NORTH LAMAR BLVD",
            "address_2": "SUITE C",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553710",
            "telephone_number": "870-338-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N POPLAR ST",
            "city": "MARIANNA",
            "state": "AR",
            "postal_code": "723602318",
            "telephone_number": "870-295-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS CLINIC COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-04",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "ATTORNEY",
        "authorized_official_telephone_number": "501-786-4007"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marianna Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marianna Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marianna, AR

Sources for this page

Verify at the official NPI Registry.