NPIMap

Access Medical Clinic Arkansas LLC

Organization Active NPI Rural Health Clinic/Center · Camden, AR

NPI 1508563362 · NPPES record last updated Nov 6, 2024

Key facts

NPI
1508563362
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
ACCESS MEDICAL CLINIC ARKANSAS LLC
Practice address
476 Hospital Dr Ste 2
Camden, AR 71701-4652
Phone
(870) 390-4245
NPI assigned
Feb 13, 2023
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 2

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

  • Randi L Davis, APRN Family Nurse Practitioner · Bay, AR · NPI 1740622497
    CMS ownership CORPORATE DIRECTOR · OPERATIONAL/MANAGERIAL CONTROL · W-2 MANAGING EMPLOYEE
  • Mark S Hahn, DO Family Medicine Physician · Caraway, AR · NPI 1609895911
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · CORPORATE DIRECTOR

Other NPIs on the same Medicare enrollment 43

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

View all 43

Corporate family (same tax ID) 19

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

Practitioners 190

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 190

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2276862Access Medical Clinic Arkansas LLC
476 Hospital Dr, Camden, AR 71701		Certificate of waiverFeb 15, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in AR

Rural health clinic certification: CCN 043944

Legal name
ACCESS MEDICAL CLINIC ARKANSAS LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 22, 2024
Last certification
Jul 22, 2024
Ownership / control type
1C
Organization structure
LLC · Proprietary
Incorporated
Dec 2, 2016 in AR
Enrollment address
476 Hospital Dr
Ste 2
Camden, AR 71701-4652

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Howard Freeman
Individual 		Corporate Director
SVP Clinics Divison		 May 13, 2026
W-2 Managing Employee
Ad;		 May 13, 2026
Operational/Managerial Control
SVP Clinics Divison		 May 13, 2026
Mark Hahn
Individual 		5% Or Greater Direct Ownership Interest May 8, 2025
Corporate Director
Medical Director		 May 8, 2025
Tony D James
Individual 		Corporate Officer
Cfo		 May 13, 2026
W-2 Managing Employee
Ad;		 May 13, 2026
Jared Clifford
Individual 		Corporate Officer
Ceo		 May 13, 2026
W-2 Managing Employee
Ad;		 May 8, 2025
Monya York
Individual 		Corporate Director
Credentialing Director		 May 8, 2025
W-2 Managing Employee
Ad;		 May 8, 2025
Randi L Davis
Individual 		Corporate Director
Sr Director Clinics Operations		 May 13, 2026
W-2 Managing Employee
Ad;		 May 8, 2025
Operational/Managerial Control
Sr Director Clinics Operations		 May 13, 2026
Kasey Crawford
Individual 		Corporate Director
Director Clinics Operation		 May 13, 2026
W-2 Managing Employee
Ad;		 May 13, 2026
Operational/Managerial Control
Director Clinics Operation		 May 13, 2026

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Access Medical Clinic Arkansas LTC LLC
Lonoke, AR · CCN 043913		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 24, 2023
Access Medical Clinic Arkansas LTC LLC
Weiner, AR · CCN 043885		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 24, 2023
Access Medical Clinic Arkansas LTC LLC
Malvern, AR · CCN 043910		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 24, 2023
Access Medical Clinic Arkansas LTC LLC
Greenbrier, AR · CCN 043909		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 24, 2023
Access Medical Clinic Arkansas LTC LLC
Marshall, AR · CCN 043894		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 24, 2023
Access Medical Clinic Arkansas LTC LLC
Perryville, AR · CCN 043898		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 24, 2023
Access Medical Clinic Arkansas LTC LLC
Concord, AR · CCN 043891		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 24, 2023
Access Medical Clinic Arkansas
Cave City, AR · CCN 043915		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 24, 2023

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170124001288 AR Part B Supplier - Clinic/Group Practice 5890077093 Receives reassigned benefits from 171 practitioners
43 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Heber Springs, AR; Hope, AR; Lamar, AR; Mena, AR; Mountain Home, AR; Newport, AR; Osceola, AR; Ozark, AR…
O20240413000146 AR Part a Provider - Rural Health Clinic 5890077093 Practice locations: Camden, AR

National Provider Directory

Tax ID family
Access Medical Clinic Arkansas LLC (20 organizations share this tax ID)

Locations

234 Highway 274
Camden, AR 71701
Phone (870) 390-4245

476 Hospital Dr
Camden, AR 71701
Phone (870) 800-9002

2280 E Main St
El Dorado, AR 71730
Phone (870) 444-5216

1248 W Keiser Ave
Osceola, AR 72370
Phone (870) 576-9974

871 E Heritage Pkwy
Prairie Grove, AR 72753
Phone (479) 487-2001

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

476 Hospital Dr Ste 2
Camden, AR 71701-4652

Mailing address

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

Other providers in Camden, AR

All providers in Camden, AR · Rural Health Clinic/Center in Arkansas

Sources for this page

Verify at the official NPI Registry.