NPIMap

Organization Active NPI

Cabun Rural Health Services, Inc

Doing business as Lewisville Family Practice Center

  • Federally Qualified Health Center (FQHC)
  • Lewisville, AR
National Provider Identifier
1437193646
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CABUN RURAL HEALTH SERVICES, INC
Doing business as
Lewisville Family Practice Center
Practice address
1117 Chestnut Street
Lewisville, AR 71845
Phone
(870) 921-5781
Fax
(870) 921-4510
NPI assigned
Jun 16, 2006
Last updated
Aug 24, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CABUN RURAL HEALTH SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Authorized official

Name
Susan Diane Johnston, LPN, LRT, RMC
Title
Billing Supervisor
Phone
(870) 798-3515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1117 Chestnut Street
Lewisville, AR 71845

Mailing address

PO Box 1013
Lewisville, AR 71845-1013
Phone (870) 921-5781

Other identifiers 1

IdentifierTypeStateIssuer
122632749MedicaidAR

Other names 1

  • Lewisville Family Practice Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040113000620 AR Part B Supplier - Clinic/Group Practice 9133029234 Receives reassigned benefits from 11 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hampton, AR; Strong, AR; Lewisville, AR; Hope, AR; Bearden, AR; Amity, AR
O20060818000544 AR Part A Provider - Federally Qualified Health Center (FQHC) 9133029234 Practice locations: Lewisville, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437193646. Details of each certification follow.

Federally qualified health center certification: CCN 041825

Legal name
CABUN RURAL HEALTH SERVICES, INC
Doing business as
LEWISVILLE FAMILY PRACTICE CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 25, 1977 in AR
Enrollment address
1117 Chestnut St
Lewisville, AR 71845

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 5

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
04D0859556Lewisville Family Practice Center1117 South Chestnut Street, Lewisville, AR 71845ComplianceNov 24, 2026

National Provider Directory

National Provider Directory
Tax ID family
Cabun Clinic9 organizations share this tax ID, including this one
Part of
Cabun Clinic

Other organizations with this tax ID 8

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

Locations

150 N School St
Bearden, AR 71720
Phone (501) 622-4866

205 Smith Rd
Ste D
Hope, AR 71801
Phone (870) 777-8420

253 S Concord
Strong, AR 71765
Phone (870) 797-7620

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Melanie J Sheppard Individual Corporate OfficerCeo Apr 1, 2009 50%
W-2 Managing EmployeeCeo Apr 1, 2009
Operational/Managerial ControlCeo Oct 17, 2016
Susan D Johnston Individual Corporate OfficerCio Nov 1, 2005
W-2 Managing EmployeeCio Oct 1, 2009
Operational/Managerial ControlCio Oct 17, 2016
James C Rawls Individual Corporate DirectorBoard Chair Apr 1, 2009
Marsha Luna Individual Corporate DirectorBoard Member Jan 2, 2022
Sandra J Gaskin Individual Corporate DirectorBoard Member Apr 1, 1995
Judy K Southall Individual W-2 Managing EmployeeCfo Jan 2, 2022
Tracy L Madlock Individual Corporate OfficerCoo Oct 17, 2016
W-2 Managing EmployeeCoo Oct 17, 2016
Operational/Managerial ControlCoo Oct 17, 2016
Donald R Cain Individual Corporate DirectorBoard Member Apr 1, 1999
Garry B Johns Individual Corporate DirectorBoard Member Jan 2, 2022
Travis J McNiel Individual Corporate DirectorBoard Member Mar 28, 2011
Vester Lambert Individual Corporate DirectorBoard Member Jan 2, 2022
Lillie M Randall Individual Corporate DirectorBoard Vice Chair Apr 1, 1995
Adam Bailey Individual Corporate OfficerSecretary Treasurer Jan 2, 2022

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787529600000",
    "number": "1437193646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1013",
            "city": "LEWISVILLE",
            "state": "AR",
            "postal_code": "718451013",
            "telephone_number": "870-921-5781",
            "fax_number": "870-921-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 CHESTNUT STREET",
            "city": "LEWISVILLE",
            "state": "AR",
            "postal_code": "71845",
            "telephone_number": "870-921-5781",
            "fax_number": "870-921-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CABUN RURAL HEALTH SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CABUN RURAL HEALTH SERVICES, INC",
        "enumeration_date": "2006-06-16",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "870-798-3515",
        "authorized_official_credential": "LPN, LRT, RMC"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122632749",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lewisville Family Practice Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewisville, AR

Sources for this page

Verify at the official NPI Registry.