NPIMap

Organization Active NPI

Great River Medical Center LLC

Doing business as Mississippi County Primary Care Physicians Clinic

  • Rural Health Clinic/Center
  • Osceola, AR
National Provider Identifier
1275451817
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GREAT RIVER MEDICAL CENTER LLC
Doing business as
Mississippi County Primary Care Physicians Clinic
Practice address
602 W Union Ave Ste B
Osceola, AR 72370-3022
Phone
(870) 563-6504
NPI assigned
Jul 9, 2026
Last updated
Jul 9, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
GREAT RIVER MEDICAL CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Authorized official

Name
Lacey Carter
Title
Ceo
Phone
(870) 838-7460

Specialties & licenses 1

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

Addresses

Primary practice location

602 W Union Ave Ste B
Osceola, AR 72370-3022

Mailing address

PO Box 108
Blytheville, AR 72316-0108

Other names 1

  • Mississippi County Primary Care Physicians Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Great River Medical Center LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1783555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1275451817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723160108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W UNION AVE STE B",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723703022",
            "telephone_number": "870-563-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER MEDICAL CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREAT RIVER MEDICAL CENTER LLC",
        "enumeration_date": "2026-07-09",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-838-7460"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mississippi County Primary Care Physicians Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osceola, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.