1St Choice Healthcare Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Pocahontas, AR
NPI 1366498735 · NPPES record last updated Dec 14, 2023
Key facts
- NPI
- 1366498735
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- 1ST CHOICE HEALTHCARE INC
- Practice address
- 1016 McQuay Ave
Pocahontas, AR 72422 - Phone
- (870) 892-9949
- Fax
- (870) 892-0208
- NPI assigned
- May 26, 2006
- Reactivated
- Jun 9, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- 1ST CHOICE HEALTHCARE, INC.
Authorized official
- Name
- Sydney Stevens
- Title
- Chief Operating Officer
- Phone
- (870) 857-3334
Owned or controlled facilities with NPI records 2
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 5
Related certifications (CCN) 1
Practitioners 39
-
Carrie Hunter, M.D.
-
Navin Mangroo, DO
-
Rickey L McGath, M.D.
-
Haley A Tyler, APRN-FNP
-
Amanda Jane Billingsley, APRN, FNP
-
Charrae G Burdin, APRN
-
Calixto Cazano, M.D.
-
Juan B Cazano, M.D.
-
Lauren Elizabeth Crews, APRN
-
Casey Duncan, APRN
-
Tracey L Frier, LCSW
-
Sonya Kay Goode, LCSW
-
Sandra A Green, APRN-CNS
-
Jessica Leann Martin, LCSW
-
Almalea B Miller, DO
-
Heather Nicole Phillips, LCSW
-
Rebecca Plumlee Phillips, M.D.
-
Leah Christen Privett, A.P.N.
-
Jessica Reagan, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0970848 | 1St Choice Healthcare, Inc | Accreditation | Jun 6, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR
Federally qualified health center certification: CCN 041840
- Legal name
- 1ST CHOICE HEALTHCARE INC
- Doing business as
- 1ST CHOICE HEALTHCARE
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 20, 2000
- Last certification
- Jan 20, 2000
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 3, 1992 in AR
- Enrollment address
- 1016 McQuay Ave
Pocahontas, AR 72455-2407 - Related CCNs
- 041832
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Freda Adams |
W-2 Managing Employee |
Sep 5, 2023 | |
| Paul Carr |
Corporate Director |
Jul 1, 2024 | |
| Patricia Patterson |
Corporate Director |
Jul 1, 2024 | |
| Greg Mock |
Corporate Director |
Jul 1, 2021 | |
| Diana Dalton |
Corporate Director |
Jan 1, 2025 | |
| Randy Goodman |
Corporate Director |
Jul 1, 2023 | |
| Pat Johnson |
Corporate Director |
Jul 1, 2025 | |
| Brenda Poindexter |
Corporate Director |
Aug 1, 2022 | |
| Josh Gooch |
Corporate Director |
Jul 1, 2021 | |
| Sydney Stevens |
Corporate Officer |
Jan 1, 2023 | |
| W-2 Managing Employee |
Oct 31, 2022 | ||
| Operational/Managerial Control |
Jan 1, 2023 | ||
| Joey Radcliff |
Corporate Director |
May 28, 2018 | |
| W-2 Managing Employee |
May 28, 2018 | ||
| Jerry Phillips |
Corporate Director |
Jul 1, 2021 | |
| Joie Saienni |
Corporate Director |
Jul 1, 2021 | |
| Bonnie White |
Corporate Officer |
Jul 1, 2021 | |
| Nick Manatt |
Corporate Director |
Jul 1, 2021 | |
| Brigitte McDonald |
Corporate Officer |
Jun 29, 2010 | 100% |
| W-2 Managing Employee |
Jun 29, 2010 | ||
| Operational/Managerial Control |
Jun 29, 2010 | 100% | |
| Larry Lawrence |
Corporate Director |
Jul 1, 2021 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| 1St Choice Healthcare Inc |
Federally qualified health center | Operational/Managerial Control | Jun 20, 1996 |
| 1St Choice Healthcare Inc |
Federally qualified health center | Operational/Managerial Control | Apr 17, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100427000059 | AR | Part B Supplier - Clinic/Group Practice | 0648184218 |
Receives reassigned benefits from 41 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Walnut Ridge, AR; Salem, AR; Pocahontas, AR; Highland, AR; Paragould, AR; Corning, AR |
| O20100621000892 | AR | Part a Provider - Federally Qualified Health Center (FQHC) | 0648184218 | Practice locations: Pocahontas, AR |
National Provider Directory
- Part of
- Corning Area Healthcare Inc
Locations
1016 McQuay Ave
Pocahontas, AR 72455
Phone (870) 892-9949
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
1016 McQuay Ave
Pocahontas, AR 72422
Mailing address
PO Box 83
Corning, AR 72422-0083
Phone (870) 857-3334
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5B451 | Other | AR | AR BCBS PROVIDER NUMBER |
| 139315749 | Medicaid | AR | |
| 504849605 | Medicaid | MO |
Other names
- 1st Choice Healthcare
Other providers in Pocahontas, AR
- 1St Advantage Home Care Inc
- 1St Class Home Care
- Above & Beyond Home Care LLC
- Jonathan Ahle
- Al Pocahontas Operations, LLC
- Lexie Alphin
All providers in Pocahontas, AR · Federally Qualified Health Center (FQHC) in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2023. 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.