NPIMap

Organization Active NPI

Mainline Health Systems, Inc

Doing business as Mainline Center for Healthy Living

  • Federally Qualified Health Center (FQHC)
  • Star City, AR
National Provider Identifier
1306753975
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MAINLINE HEALTH SYSTEMS, INC
Doing business as
Mainline Center for Healthy Living
Star City II
Practice address
612 E Arkansas St
Star City, AR 71667-4842
Phone
(870) 628-5110
Fax
(855) 854-6281
NPI assigned
Aug 27, 2026
Last updated
Aug 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Authorized official

Name
Elyse Knobloch
Title
Chief Financial Officer
Phone
(870) 538-5412

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

612 E Arkansas St
Star City, AR 71667-4842

Mailing address

342 Highway 425 S
Monticello, AR 71655-4612
Phone (870) 942-3000

Other names 2

  • Mainline Center for Healthy Living Doing business as
  • Star City II Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sanyasi R Ganta MD36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1306753975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 HIGHWAY 425 S",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554612",
            "telephone_number": "870-942-3000",
            "fax_number": "870-942-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 E ARKANSAS ST",
            "city": "STAR CITY",
            "state": "AR",
            "postal_code": "716674842",
            "telephone_number": "870-628-5110",
            "fax_number": "855-854-6281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINLINE HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "KNOBLOCH",
        "authorized_official_first_name": "ELYSE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "870-538-5412"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mainline Center for Healthy Living",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Star City II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Star City, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.