NPIMap

Organization Active NPI

MMC Rural Health Clinics, PLLC

Doing business as MMC2

  • Rural Health Clinic/Center
  • Monticello, AR
National Provider Identifier
1043716525
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MMC RURAL HEALTH CLINICS, PLLC
Doing business as
MMC2
Practice address
733 Roberts Drive
Monticello, AR 71655
Phone
(870) 367-6867
Fax
(870) 367-1461
NPI assigned
Apr 3, 2018
Last updated
Apr 3, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Sylvia Chambers Simon, M.D.NPI 1639159676
Title
Medical Director
Phone
(870) 723-4513

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

733 Roberts Drive
Monticello, AR 71655

Mailing address

733 Roberts Drive
Monticello, AR 71655
Phone (870) 367-6867

Other names 1

  • MMC2 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Hospital Assn Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Feb 1, 2022 Change of OwnershipThis provider was the seller Jefferson Regional Monticello Medical ClinicCCN 048533, AR, NPI 1821749946

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 1

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": "1522713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1043716525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 ROBERTS DRIVE",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "71655",
            "telephone_number": "870-367-6867",
            "fax_number": "870-367-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 ROBERTS DRIVE",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "71655",
            "telephone_number": "870-367-6867",
            "fax_number": "870-367-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMC RURAL HEALTH CLINICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_middle_name": "CHAMBERS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "870-723-4513",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMC2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, AR

Sources for this page

Verify at the official NPI Registry.