NPIMap

Organization Active NPI

Monticello Medical Clinic PLC

  • Clinic/Center
  • Monticello, AR
National Provider Identifier
1366422305
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MONTICELLO MEDICAL CLINIC PLC
Practice address
906 Roberts Dr
Monticello, AR 71655-5724
Phone
(870) 367-6867
Fax
(870) 367-1461
NPI assigned
Jan 17, 2006
Last updated
Apr 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Authorized official

Name
Sylvia Simon, MDNPI 1639159676
Title
Partner
Phone
(870) 367-6867

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

906 Roberts Dr
Monticello, AR 71655-5724

Mailing address

906 Roberts Dr
Monticello, AR 71655-5724
Phone (870) 367-6867

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1366422305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 ROBERTS DR",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716555724",
            "telephone_number": "870-367-6867",
            "fax_number": "870-367-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 ROBERTS DR",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716555724",
            "telephone_number": "870-367-6867",
            "fax_number": "870-367-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO MEDICAL CLINIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "870-367-6867",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.