Magnolia Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MAGNOLIA SURGERY CENTER, LLC

Practice address

25 Columbia Road 47
Magnolia, AR 71753

Phone

(870) 234-5665

Fax

(870) 234-5665

NPI assigned

Jul 20, 2012

Last updated

Aug 20, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ivory A KinslowNPI 1972575702

Title

Owner/Medical Director

Phone

(870) 234-5665

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Listed as

Magnolia Surgery Center LLCCCN 04C0001087

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Practitioners 4

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.

• Ivory Amelia Kinslow, MD

  • Ophthalmology Physician
  • El Dorado, AR
  • NPI 1972575702
  Medicare reassignment NPD Authorized official
• Harvinder S Dod, MD

  • Cardiovascular Disease Physician
  • El Dorado, AR
  • NPI 1699983635
  Medicare reassignment NPD
• Daniel D Schrader, MD

  • Cardiovascular Disease Physician
  • El Dorado, AR
  • NPI 1689634982
  Medicare reassignment NPD
• Kristin E Christian, OD

  • Optometrist
  • El Dorado, AR
  • NPI 1902813314
  NPD

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1043565542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 COLUMBIA ROAD 47",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "71753",
            "telephone_number": "870-234-5665",
            "fax_number": "879-234-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 COLUMBIA ROAD 47",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "71753",
            "telephone_number": "870-234-5665",
            "fax_number": "870-234-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "KINSLOW",
        "authorized_official_first_name": "IVORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "870-234-5665",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "295574",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Magnolia Regional Medical Center
• Magnolia Regional Medical Center
• Magnolia Regional Medical Center
• Magnolia School District 14 (Magnolia Public Schools)
• Magnolia Specialized Services, Inc.
• Mainline Health Systems, Inc (Mainline Health Magnolia Clinic)
• Jeremy Jini Malone
• Sandra K Manning, MHPP
• Gregory Lynn Martin, D.D.S.
• Sheila K Martin, COTA/L

• Ambulatory Surgical Clinic/Center in Magnolia, AR
• Providers in Magnolia, AR by specialty
• Ambulatory Surgical Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.