NPIMap

Organization Active NPI

Access Medical Clinic LLC

Doing business as Access Medical Clinic Indiana

  • Rural Health Clinic/Center
  • Oakland City, IN
National Provider Identifier
1407537137
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ACCESS MEDICAL CLINIC LLC
Doing business as
Access Medical Clinic Indiana
Practice address
1000 W Morton St Ste Am
Oakland City, IN 47660-7617
Phone
(479) 388-0446
NPI assigned
Jul 26, 2023
Last updated
Feb 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Authorized official

Name
Monya York
Title
Controller
Phone
(870) 856-1202

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

1000 W Morton St Ste Am
Oakland City, IN 47660-7617

Mailing address

4196 Highway 62 412 Ste a
Hardy, AR 72542-8002

Other names 1

  • Access Medical Clinic Indiana Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220930001534 IN Part B Supplier - Clinic/Group Practice 1951721802 Receives reassigned benefits from 15 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Crawfordsville, IN; Greensburg, IN; Oakland City, IN
O20230831004437 IN Part A Provider - Rural Health Clinic 1951721802 Practice locations: Oakland City, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407537137. Details of each certification follow.

Rural health clinic certification: CCN 153947

Legal name
ACCESS MEDICAL CLINIC LLC
Doing business as
ACCESS MEDICAL CLINIC INDIANA
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 27, 2023
Last certification
Dec 27, 2023
Ownership / control type
1A
Organization structure
LLCProprietary
Enrollment address
1000 W Morton St
Ste Am
Oakland City, IN 47660-7697

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2287102Access Medical Clinic LLC1000 W Morton St Ste Am, Oakland City, IN 47660Certificate of waiverAug 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Access Medical Clinic11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mark Hahn Individual 5% Or Greater Direct Ownership InterestDO May 8, 2025 100%
Corporate OfficerMedical Director May 8, 2025
Jared Clifford Individual Corporate OfficerPresident May 8, 2025
Sheri N Davis Individual W-2 Managing EmployeeVP of Provider Mgmnt May 8, 2025
Monya York Individual Corporate DirectorDirector Credentialing Jul 1, 2017
W-2 Managing EmployeeDirector Credentialing Jul 1, 2017
Operational/Managerial ControlDirector Credentialing Jul 1, 2017
Randi L Davis Individual W-2 Managing EmployeeDirector Provider Mgmnt May 8, 2025
Candice M Cartwright Individual W-2 Managing EmployeeVP Operations May 8, 2025

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

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": "1690329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1407537137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4196 HIGHWAY 62 412 STE A",
            "city": "HARDY",
            "state": "AR",
            "postal_code": "725428002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W MORTON ST STE AM",
            "city": "OAKLAND CITY",
            "state": "IN",
            "postal_code": "476607617",
            "telephone_number": "479-388-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-26",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "YORK",
        "authorized_official_first_name": "MONYA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "870-856-1202"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Access Medical Clinic Indiana",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Access Medical Clinic Indiana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland City, IN

Sources for this page

Verify at the official NPI Registry.