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Dardanelle Regional, LLC

Organization Active NPI Psychiatric Hospital Unit · Dardanelle, AR

NPI 1205940236 · NPPES record last updated Aug 3, 2023

Key facts

NPI
1205940236
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric Hospital Unit 273R00000X
Legal business name
DARDANELLE REGIONAL, LLC
Practice address
200 North 3Rd Street
Dardanelle, AR 72834
Phone
(479) 229-4677
Fax
(479) 229-6162
NPI assigned
Aug 18, 2006
Organization subpart
No

Authorized official

Name
Brandy Talley
Title
Controller
Phone
(479) 229-4677

Owners & managing parties with NPI records 3

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

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 3

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

Corporate family (same tax ID) 5

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 7

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

Practitioners 16

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR

Hospital certification: CCN 04M302

Legal name
DARDANELLE REGIONAL LLC
Doing business as
DARDANELLE REGIONAL MEDICAL CENTER
Organization structure
LLC · Non-profit
Incorporated
Apr 25, 2019 in AR
Enrollment address
200 N 3Rd Street
Dardanelle, AR 72834-3802
Hospital Swing-Bed Unit

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Dardanelle Regional LLC
Organization · Dardanelle, AR
LLC 		5% Or Greater Direct Ownership Interest Jan 1, 2022 100%
Conway Regional Medical Center Inc
Organization · Conway, AR
Corporation 		5% Or Greater Indirect Ownership Interest Jan 1, 2022 100%
Alan Finley
Individual 		Corporate Director
Board Member		 Jan 1, 2022 100%
W-2 Managing Employee
Ceo		 Jan 1, 2022 100%
Operational/Managerial Control
Chief Executive Officer		 Jun 1, 2019 100%

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Dardanelle Regional Medical Center
Dardanelle, AR · CCN 04Z302		 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2022
Dardanelle Regional Medical Center
Dardanelle, AR · CCN 041302		 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220525002921 AR Part a Provider - Critical Access Hospital 0345576500 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: Dardanelle, AR

National Provider Directory

Tax ID family
Dardanelle Regional LLC (6 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207P00000X
Psychiatric Hospital Unit 273R00000X Yes

Addresses

Primary practice location

200 North 3Rd Street
Dardanelle, AR 72834

Mailing address

200 North 3Rd Street
Dardanelle, AR 72834
Phone (479) 229-4677

Other names

  • Dardanelle Regional Medical Center Doing business as

Other providers in Dardanelle, AR

All providers in Dardanelle, AR · Psychiatric Hospital Unit in Arkansas

Sources for this page

Verify at the official NPI Registry.