NPIMap

Organization Active NPI

Magnolia Regional Medical Center

  • Rural Health Clinic/Center
  • Magnolia, AR
National Provider Identifier
1093298580
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MAGNOLIA REGIONAL MEDICAL CENTER
Practice address
104 Hospital Dr
Magnolia, AR 71753-2416
Phone
(870) 235-3000
NPI assigned
Sep 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Authorized official

Name
Mr. Rex E Jones
Title
Chief Executive Officer
Phone
(870) 235-3212

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

104 Hospital Dr
Magnolia, AR 71753-2416

Mailing address

PO Box 629
Magnolia, AR 71754-0629
Phone (870) 235-3000

Other names 1

  • Magnolia Family Medical Clinic Other name

Medicare participation

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

National Provider Directory

National Provider Directory

Locations

1010 N Dudney Rd
Ste C
Magnolia, AR 71753
Phone (870) 234-2675

707 N Washington
Magnolia, AR 71753
Phone (870) 235-3000

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Oct 1, 2020 Change of OwnershipThis provider was the seller Magnolia Regional Health System IncCCN 048519, AR, NPI 1548881386

Change of ownership 1

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1536624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1093298580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717540629",
            "telephone_number": "870-235-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HOSPITAL DR",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532416",
            "telephone_number": "870-235-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-11",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "870-235-3212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Family Medical Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Magnolia Family Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Magnolia, AR

Sources for this page

Verify at the official NPI Registry.