Organization Active NPI

Irvin & Dibrell Medical Clinic, PA

  • Family Medicine Physician
  • Mountain View, AR
National Provider Identifier
1669492575
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
IRVIN & DIBRELL MEDICAL CLINIC, PA
Practice address
803 West Main
Mountain View, AR 72560
Phone
(870) 269-9800
Fax
(870) 269-9614
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Authorized official

Name
Dr. John D Irvin, M.D.
Title
President
Phone
(870) 269-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

803 West Main
Mountain View, AR 72560

Mailing address

P. O. Box 106
Mountain View, AR 72560
Phone (870) 269-9800

Other identifiers 2

IdentifierTypeStateIssuer
DB3125OtherARRAILROAD MEDICARE
5C651OtherARBLUE CROSS BLUE SHIELD

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
04D1001492Irvin and Dibrell Medical Clinic PA803 West Main, Mountain View, AR 72560Certificate of waiverJul 11, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1669492575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 106",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "72560",
            "telephone_number": "870-269-9800",
            "fax_number": "870-269-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 WEST MAIN",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "72560",
            "telephone_number": "870-269-9800",
            "fax_number": "870-269-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVIN & DIBRELL MEDICAL CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "IRVIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-269-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB3125",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5C651",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.