NPIMap

Organization Active NPI

Morrilton Medical Clinic, P.a.

  • Rural Health Clinic/Center
  • Morrilton, AR
National Provider Identifier
1083989040
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MORRILTON MEDICAL CLINIC, P.A.
Practice address
10 Hospital Dr
Morrilton, AR 72110-4510
Phone
(501) 354-0052
Fax
(501) 354-9142
NPI assigned
Mar 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Authorized official

Name
Matthew Stengel
Title
Clinic Administrator
Phone
(501) 354-0052

Specialties & licenses 1

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

Addresses

Primary practice location

10 Hospital Dr
Morrilton, AR 72110-4510

Mailing address

10 Hospital Dr
Morrilton, AR 72110-4510
Phone (501) 354-0052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040517001618 AR Part B Supplier - Clinic/Group Practice 2860482130 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Morrilton, AR
O20140602001101 AR Part A Provider - Rural Health Clinic 2860482130 Practice locations: Morrilton, AR

Rural health clinic certification: CCN 043878

Legal name
MORRILTON MEDICAL CLINIC, P.A.
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 12, 2014
Last certification
Sep 12, 2018
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Dec 4, 1984 in AR
Enrollment address
10 Hospital Dr
Morrilton, AR 72110-4510

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Robert J Wilkerson Individual 5% Or Greater Direct Ownership Interest Dec 4, 1984 16.66%
Corporate OfficerShareholder Dec 4, 1984 16.66%
Charles Eugene Howard Individual 5% Or Greater Direct Ownership Interest Jul 1, 2003 16.66%
Corporate OfficerShareholder Jul 1, 2003 16.66%
Matthew Stengel Individual W-2 Managing EmployeeAd; Jul 16, 2020
Operational/Managerial ControlClinic Administrator Jul 16, 2020
Dustin Creech Individual 5% Or Greater Direct Ownership Interest Sep 1, 2018 16.66%
Corporate OfficerShareholder Sep 1, 2018 16.66%
Peter J Post Individual 5% Or Greater Direct Ownership Interest Dec 4, 1984 16.66%
Corporate OfficerSecretary Treasurer Dec 4, 1984 16.66%
Lydia C Trauth Individual 5% Or Greater Direct Ownership Interest Jul 1, 2012 16.66%
Corporate OfficerShareholder Jul 1, 2012 16.66%
Jack a Lyon Individual 5% Or Greater Direct Ownership Interest Jul 1, 1990 16.7%
Corporate OfficerShareholder Jul 1, 1990 16.7%

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786060800000",
    "number": "1083989040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HOSPITAL DR",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "721104510",
            "telephone_number": "501-354-0052",
            "fax_number": "501-354-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HOSPITAL DR",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "721104510",
            "telephone_number": "501-354-0052",
            "fax_number": "501-354-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRILTON MEDICAL CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-09",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A",
        "authorized_official_last_name": "STENGEL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "501-354-0052"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrilton, AR

Sources for this page

Verify at the official NPI Registry.