John Ed Chambers Memorial Hospital, Inc.
Organization Active NPI Primary Care Clinic/Center · Havana, AR
NPI 1346431384 · NPPES record last updated Apr 28, 2026
Key facts
- NPI
- 1346431384
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- JOHN ED CHAMBERS MEMORIAL HOSPITAL, INC.
- Practice address
- 310 West Broadway
Havana, AR 72842-0099 - Phone
- (479) 476-2827
- Fax
- (479) 476-2580
- NPI assigned
- Aug 6, 2007
- Organization subpart
- No
Authorized official
- Name
- Michael Scott Peek
- Title
- Ceo
- Phone
- (479) 495-2241
Owners & managing parties with NPI records 5
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 6
Related certifications (CCN) 3
Practitioners 6
-
Robin Q Goodman, MD
-
Morgan Lynne Hayes, APRN
-
Kathryn E Pledger, CNP
-
Zachary Tippin, M.D.
-
Cynthia Renee Day, A.P.N.
Affiliated clinicians 42
-
Sahibzada A Ahmed, M.D.
-
Michelle Jean Banning, M.D.
-
William L Berry, M.D.
-
W Bruce Brown, M.D.
-
Cindy Nicole Burnett, APRN
-
Michaela Caldarera, APRN
-
Jefferson Cartwright, M.D.
-
Scott A Davis, MD
-
Cynthia Renee Day, A.P.N.
-
Pamela Lou Dollar, APRN
-
Hailey C Farris, M.D.
-
Shannon Golden, APN
-
Jeffrey Hale, MD
-
Drew Courtney Heiple, M.D.
-
Samuel L Hughes, MD
-
Peggy Isaac, CNP
-
Lisa M Ivy, ANP
-
Kayla Renee Johnson, APRN
-
Owen L Kelly, MD
-
Allan K Kirkland, MD
Medicare Care Compare: Hospital
- Listed as
- Chambers Memorial Hospital
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D1073725 | Western Yell County Medical Clinic | Compliance | Jan 5, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR
Hospital certification: CCN 040011
- Legal name
- JOHN ED CHAMBERS MEMORIAL HOSPITAL INC
- Doing business as
- CHAMBERS MEMORIAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Jul 30, 2021
- Beds
- 42
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 29, 1997 in AR
- Enrollment address
- 719 Detroit Avenue
Danville, AR 72833-0639 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| John Chambers |
Corporate Director | Mar 12, 1984 | |
| Michael Peek |
Corporate Officer |
Jun 1, 2021 | 100% |
| W-2 Managing Employee |
Jun 1, 2021 | 100% | |
| Operational/Managerial Control |
Jun 1, 2021 | 100% | |
| Tommy D Papasan |
Corporate Director |
Jul 16, 2014 | |
| John Ed Chambers Memorial Hospital Inc |
Operational/Managerial Control | Jun 1, 2021 | 100% |
| Philip Alexander |
Corporate Director | Aug 18, 2004 | |
| Paul Sanders |
Corporate Director | Jul 1, 1995 | |
| Kayla Walker |
W-2 Managing Employee |
Jun 1, 2021 | 1% |
| Operational/Managerial Control |
Jun 1, 2021 | 1% | |
| Paula M Cornwell |
Corporate Officer |
Jan 1, 2021 | |
| W-2 Managing Employee |
Jun 1, 2021 | 1% | |
| Operational/Managerial Control |
Jun 1, 2021 | 1% | |
| David Fisher |
Corporate Director | Jul 9, 1984 | |
| Ritchie Tippin |
Corporate Director | Jul 14, 1986 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050308000661 | AR | Part B Supplier - Clinic/Group Practice | 4688628167 |
Receives reassigned benefits from 17 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Danville, AR; Plainview, AR; Havana, AR; Ola, AR |
| O20070313000287 | AR | Part a Provider - Hospital | 4688628167 |
4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Danville, AR; Plainview, AR; Havana, AR; Ola, AR |
National Provider Directory
- Tax ID family
- Chambers Memorial Hospi
Locations
310 W Broadway
Havana, AR 72842
Phone (479) 476-2827
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
310 West Broadway
Havana, AR 72842-0099
Mailing address
PO Box 99
Havana, AR 72842-0099
Phone (479) 476-2827
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113073002 | Medicaid | AR | |
| 57988 | Other | AR | BLUE CROSS |
Other names
- Western Yell County Medical Clinic
Other providers in Havana, AR
- Cynthia Renee Day
- Julie Christine Foster
- Patty K Pettway
- Western Yell County School
- Western Yell County School
- Western Yell County School Dist
All providers in Havana, AR · Primary Care Clinic/Center in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.