Access Medical Clinic Arkansas LTC LLC

Organization Active NPI Rural Health Clinic/Center · Weiner, AR

NPI 1114578929 · NPPES record last updated Aug 25, 2025

Key facts

NPI
1114578929
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
ACCESS MEDICAL CLINIC ARKANSAS LTC LLC
Practice address
106 N Van Buren St
Weiner, AR 72479-9289
Phone
(870) 605-0014
Fax
(501) 468-0472
NPI assigned
Sep 23, 2019
Organization subpart
No

Authorized official

Name
Monya York
Title
Controller
Phone
(870) 856-1202

Owners & managing parties with NPI records 4

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

Other NPIs on the same Medicare enrollment 44

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

View all 44

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Facilities with the same owner 7

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

Practitioners 164

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

View all 164

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in AR

Rural health clinic certification: CCN 043885

Legal name
ACCESS MEDICAL CLINIC ARKANSAS LTC LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 22, 2016
Last certification
Mar 3, 2021
Ownership / control type
1B
Most recent change of ownership
Jan 1, 2024 (2 total)
Organization structure
LLC · Proprietary
Incorporated
Jul 24, 2023 in AR
Enrollment address
106 N Van Buren St
Weiner, AR 72479-9289

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
Mark Hahn
Individual
5% Or Greater Indirect Ownership Interest
Medical Director
May 8, 2025 100%
Jared Clifford
Individual
Corporate Officer
President
May 8, 2025
Access Medical Clinic Arkansas LLC
Organization · Hardy, AR
LLC
5% Or Greater Direct Ownership Interest Jul 24, 2023 100%
Sheri N Davis
Individual
W-2 Managing Employee
VP of Provider Mgmnt
May 8, 2025
Monya York
Individual
W-2 Managing Employee Jul 24, 2023
Operational/Managerial Control Jul 24, 2023
Randi L Davis
Individual
W-2 Managing Employee
Director Provider Mgmnt
May 8, 2025
Candice M Cartwright
Individual
W-2 Managing Employee
Clinic Director
May 8, 2025

Change-of-ownership history

DateEventCounterparty
Jan 1, 2024 Change of Ownership
This provider was the buyer
Access Medical Clinic Arkansas LLC
CCN 043885 · AR · NPI 1114578929
Jan 1, 2024 Change of Ownership
This provider was the seller
Access Medical Clinic Arkansas LTC LLC
CCN 043885 · AR · NPI 1114578929

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170124001288 AR Part B Supplier - Clinic/Group Practice 5890077093 Receives reassigned benefits from 171 practitioners
43 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Heber Springs, AR; Hope, AR; Lamar, AR; Mena, AR; Mountain Home, AR; Newport, AR; Osceola, AR; Ozark, AR…
O20231121002796 AR Part a Provider - Rural Health Clinic 0547618175 Practice locations: Weiner, AR
O20231208000065 AR Part B Supplier - Clinic/Group Practice 0547618175 Receives reassigned benefits from 126 practitioners
9 other NPIs on this enrollment
Practice locations: Malvern, AR; Weiner, AR; Perryville, AR; Marshall, AR; Lonoke, AR; Greenbrier, AR; Concord, AR; Cave City, AR

National Provider Directory

Locations

11005 Heber Springs Rd N
Concord, AR 72523
Phone (844) 291-4901

106 Highway 62 W
Salem, AR 72576
Phone (870) 895-2762

901 E Beebe Capps Expy
#B
Searcy, AR 72143

114 N Van Buren St
Weiner, AR 72479

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

106 N Van Buren St
Weiner, AR 72479-9289

Mailing address

101 W Main St
Hardy, AR 72542-9566

Other providers in Weiner, AR

All providers in Weiner, AR · Rural Health Clinic/Center in Arkansas

Sources for this page

Verify at the official NPI Registry.