NPIMap

Organization Active NPI

Phillips Clinic Company, LLC

Doing business as Helena Medical Clinic

  • Rural Health Clinic/Center
  • Helena, AR
National Provider Identifier
1053192401
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
Helena Medical Clinic
Practice address
1803 Martin Luther King Jr Dr Ste a
Helena, AR 72342-9103
Phone
(870) 338-7441
Fax
(870) 338-7945
NPI assigned
Oct 11, 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
Laura J Fey
Title
Sr Director Physician Practice
Phone
(615) 221-3641

Specialties & licenses 1

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

Addresses

Primary practice location

1803 Martin Luther King Jr Dr Ste a
Helena, AR 72342-9103

Mailing address

1801 Martin Luther King Jr Dr
Helena, AR 72342-8998
Phone (870) 816-3900

Other names 1

  • Helena 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
O20231129000893 AR Part A Provider - Rural Health Clinic 3870576259 Practice locations: Helena, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053192401. Details of each certification follow.

Rural health clinic certification: CCN 043942

Legal name
PHILLIPS CLINIC COMPANY, LLC
Doing business as
HELENA 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
1803 Martin Luther King Jr Dr
Ste a
Helena, AR 72342-9103

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
04D2152463Helena Medical Clinic1803 Martin Luther King Jr Drive Suite a, Helena, AR 72342Certificate of waiverAug 8, 2026

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.

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
Melody Rogers Individual Corporate Director Jun 1, 2025 20%
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 20%

Facilities with the same owner 2

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

NPI Registry JSON

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1053192401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 MARTIN LUTHER KING JR DR",
            "city": "HELENA",
            "state": "AR",
            "postal_code": "723428998",
            "telephone_number": "870-816-3900",
            "fax_number": "870-816-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 MARTIN LUTHER KING JR DR STE A",
            "city": "HELENA",
            "state": "AR",
            "postal_code": "723429103",
            "telephone_number": "870-338-7441",
            "fax_number": "870-338-7945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS CLINIC COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-11",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR DIRECTOR PHYSICIAN PRACTICE",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Helena Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Helena Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Helena, AR

Sources for this page

Verify at the official NPI Registry.