Access Medical Clinic Arkansas LLC
Organization Active NPI Rural Health Clinic/Center · Rison, AR
NPI 1639698558 · NPPES record last updated Sep 19, 2025
Key facts
- NPI
- 1639698558
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- ACCESS MEDICAL CLINIC ARKANSAS LLC
- Practice address
- 217 N Main St
Rison, AR 71665 - Phone
- (888) 264-5034
- Fax
- (870) 895-2164
- NPI assigned
- Sep 12, 2017
- Organization subpart
- No
Authorized official
- Name
- Bradley Ray Bibb, MD
- Title
- Ceo
- Phone
- (870) 994-7301
Owners & managing parties with NPI records 2
-
Randi L Davis, APRN
-
Mark S Hahn, DO
Other NPIs on the same Medicare enrollment 43
Practitioners 7
-
Neeraj Bharany, M.D.
-
Morgan Anna Hashem, APRN, FNP-C
-
Charity Angela Lane, APRN
-
Shawna Renee Middleton, FNP-C
-
Pamela Marie Mounce, APN, MSN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D2137819 | Access Medical Clinic Arkansas LLC | Certificate of waiver | Oct 3, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR
Rural health clinic certification: CCN 043895
- Legal name
- ACCESS MEDICAL CLINIC ARKANSAS LLC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jan 26, 2018
- Last certification
- Jan 26, 2018
- Ownership / control type
- 1C
- Organization structure
- LLC · Proprietary
- Incorporated
- Dec 2, 2016 in AR
- Enrollment address
- 217 N Main St
Rison, AR 71665-8856
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Howard Freeman |
Corporate Director |
May 15, 2026 | |
| W-2 Managing Employee |
May 15, 2026 | ||
| Operational/Managerial Control |
May 15, 2026 | ||
| Mark Hahn |
5% Or Greater Direct Ownership Interest | May 8, 2025 | 100% |
| Corporate Director |
May 8, 2025 | ||
| Tony D James |
Corporate Officer |
May 15, 2026 | |
| W-2 Managing Employee | May 15, 2026 | ||
| Jared Clifford |
Corporate Officer |
May 15, 2026 | |
| W-2 Managing Employee |
May 8, 2025 | ||
| Monya York |
Corporate Director |
May 8, 2025 | |
| W-2 Managing Employee | May 8, 2025 | ||
| Randi L Davis |
Corporate Director |
May 15, 2026 | |
| W-2 Managing Employee |
May 8, 2025 | ||
| Operational/Managerial Control |
May 15, 2026 | ||
| Kasey Crawford |
Corporate Director |
May 15, 2026 | |
| W-2 Managing Employee |
May 15, 2026 | ||
| Operational/Managerial Control |
May 15, 2026 |
All facility ownership & control disclosures 8
| Facility | Type | Role | Since |
|---|---|---|---|
| Access Medical Clinic Arkansas LTC LLC |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 24, 2023 |
| Access Medical Clinic Arkansas LTC LLC |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 24, 2023 |
| Access Medical Clinic Arkansas LTC LLC |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 24, 2023 |
| Access Medical Clinic Arkansas LTC LLC |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 24, 2023 |
| Access Medical Clinic Arkansas LTC LLC |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 24, 2023 |
| Access Medical Clinic Arkansas LTC LLC |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 24, 2023 |
| Access Medical Clinic Arkansas LTC LLC |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 24, 2023 |
| Access Medical Clinic Arkansas |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 24, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
| O20171013002684 | AR | Part a Provider - Rural Health Clinic | 5890077093 | Practice locations: Rison, AR |
National Provider Directory
Locations
104 W State St
Caraway, AR 72419
Phone (870) 565-9205
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
217 N Main St
Rison, AR 71665
Mailing address
49 Highway 62 412
Ash Flat, AR 72513-9594
Phone (888) 264-5034
Other practice location 1
217 Main St
Rison, AR 71665
Phone (870) 994-7301
Other practice location 2
217 Main St
Rison, AR 71665
Phone (870) 994-7301
Other providers in Rison, AR
- Absolute Health Primary Care, LLC
- Kadee Cash
- City Pharmacy of Rison
- Cleveland County Ambulance Service
- Cleveland County Nursing Home, Inc.
- Cleveland County School District
All providers in Rison, AR · Rural Health Clinic/Center in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2025. 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.