NPIMap

Organization Active NPI

Access Medical Clinic LLC

Doing business as Access Medical Clinic

  • Rural Health Clinic/Center
  • Crawfordsville, IN
National Provider Identifier
1831810431
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ACCESS MEDICAL CLINIC LLC
Doing business as
Access Medical Clinic
Practice address
1641 S US Highway 231
Crawfordsville, IN 47933-9421
Phone
(865) 436-2811
NPI assigned
Sep 12, 2022
Last updated
Apr 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

1641 S US Highway 231
Crawfordsville, IN 47933-9421

Mailing address

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

Other names 2

  • Access Medical Clinic Doing business as
  • Access Medical Clinic Tennessee LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220930001534 IN Part B Supplier - Clinic/Group Practice 1951721802 Receives reassigned benefits from 15 practitioners
3 other NPIs on this enrollment
Practice locations: Crawfordsville, IN; Greensburg, IN; Oakland City, IN
O20230309000169 IN Part A Provider - Rural Health Clinic 1951721802 Practice locations: Crawfordsville, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831810431. Details of each certification follow.

Rural health clinic certification: CCN 153938

Legal name
ACCESS MEDICAL CLINIC LLC
Doing business as
ACCESS MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 29, 2023
Last certification
Sep 29, 2023
Ownership / control type
1A
Organization structure
LLCProprietary
Enrollment address
1641 S US Highway 231
Crawfordsville, IN 47933-9421

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 3

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
15D2270237Access Medical Clinic LLC1641 S US Hwy 231, Crawfordsville, IN 47933Certificate of waiverOct 11, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

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 DirectorSVP of Clinic Division May 19, 2026
W-2 Managing EmployeeAd; May 19, 2026
Operational/Managerial ControlSVP of Clinic Division May 19, 2026
Mark Hahn Individual 5% Or Greater Direct Ownership InterestDO May 8, 2025 100%
Corporate OfficerMedical Director May 8, 2025
Tony D James Individual Corporate OfficerCfo May 19, 2026
W-2 Managing EmployeeAd; May 19, 2026
Jared Clifford Individual Corporate OfficerCeo May 8, 2025
W-2 Managing EmployeeAd; May 19, 2026
Monya York Individual Corporate OfficerDirector Credentialing Jun 20, 2022
W-2 Managing EmployeeDirector Credentialing Jun 12, 2020
Operational/Managerial ControlDirector Credentialing Jun 12, 2020
Randi L Davis Individual Corporate DirectorSr Director Clinic Operations May 19, 2026
W-2 Managing EmployeeAd; May 8, 2025
Operational/Managerial ControlSr Director Clinic Operations May 19, 2026
Kasey Crawford Individual Corporate DirectorDirector Clinic Operations May 19, 2026
W-2 Managing EmployeeAd; May 19, 2026
Operational/Managerial ControlDirector Clinic Operations May 19, 2026

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

    Corporate Director, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership
  • Mark S Hahn, DO
    • Family Medicine Physician
    • Caraway, AR
    • NPI 1609895911

    5% Or Greater Direct Ownership Interest, Corporate Officer

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1831810431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4196 HIGHWAY 62 412 STE A",
            "city": "HARDY",
            "state": "AR",
            "postal_code": "725428002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 S US HIGHWAY 231",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479339421",
            "telephone_number": "865-436-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "YORK",
        "authorized_official_first_name": "MONYA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "870-856-1202"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Access Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Access Medical Clinic Tennessee LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Crawfordsville, IN

Sources for this page

Verify at the official NPI Registry.