Organization Active NPI

Machen Family Medical Clinic

  • Clinic/Center
  • Batesville, AR
National Provider Identifier
1760977524
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
A003663 Issued in AR
Legal business name
MACHEN FAMILY MEDICAL CLINIC
Practice address
1995 Harrison St
Batesville, AR 72501-7309
Phone
(870) 307-5263
NPI assigned
Jun 25, 2018
Last updated
Jun 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Authorized official

Name
Sharon Wilkins
Title
Office Manager
Phone
(870) 307-5263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X A003663 AR Primary

Addresses

Primary practice location

1995 Harrison St
Batesville, AR 72501-7309

Mailing address

1995 Harrison St
Batesville, AR 72501-7309
Phone (870) 307-5263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180810000847 AR Part B Supplier - Clinic/Group Practice 2860740644 Receives reassigned benefits from 1 practitioner
Practice locations: Batesville, AR

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
04D2151127Machen Family Medical Clinic1995 Harrison Street, Batesville, AR 72501Certificate of waiverJul 11, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1529884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529884800000",
    "number": "1760977524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017309",
            "telephone_number": "870-307-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017309",
            "telephone_number": "870-307-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACHEN FAMILY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A",
        "authorized_official_last_name": "WILKINS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-307-5263"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AR",
            "license": "A003663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.