Access Medical Clinic LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

ACCESS MEDICAL CLINIC LLC

Practice address

13 Bob Tollett Loop
Crossville, TN 38555-2835

Phone

(931) 456-6057

Fax

(873) 989-2492

NPI assigned

Oct 12, 2020

Last updated

Jan 9, 2024By the provider in NPPES

Organization subpart

No

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

Addresses

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871191874. Details of each certification follow.

• CCN 883834 Rural health clinic · Active · Details

Rural health clinic certification: CCN 883834

Legal name

ACCESS MEDICAL CLINIC LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Feb 2, 2021

Last certification

Feb 2, 2021

Ownership / control type

1C

Organization structure

LLCProprietary

Incorporated

Jun 12, 2020 in TN

Enrollment address

13 Bob Tollett Loop
Crossville, TN 38555-2835

Other NPIs with the same Medicare PAC ID 10

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

• Access Medical Clinic LLC

  dba Access Medical Clinic

  • Rural Health Clinic/Center
  • Gatlinburg, TN
  • NPI 1023621646

  1951721802

  Same PAC ID
• Access Medical Clinic LLC

  • Rural Health Clinic/Center
  • Crossville, TN
  • NPI 1548017601

  1951721802

  Same PAC ID
• Access Medical Clinic LLC

  dba Access Medical Clinic Indiana

  • Rural Health Clinic/Center
  • Greensburg, IN
  • NPI 1194410720

  1951721802

  Same PAC ID
• Access Medical Clinic LLC

  • Rural Health Clinic/Center
  • Tahlequah, OK
  • NPI 1194586461

  1951721802

  Same PAC ID
• Access Medical Clinic LLC

  • Rural Health Clinic/Center
  • Big Spring, TX
  • NPI 1376232561

  1951721802

  Same PAC ID
• Access Medical Clinic LLC

  • Rural Health Clinic/Center
  • Palestine, TX
  • NPI 1386479392

  1951721802

  Same PAC ID
• Access Medical Clinic LLC

  dba Access Medical Clinic Indiana

  • Rural Health Clinic/Center
  • Oakland City, IN
  • NPI 1407537137

  1951721802

  Same PAC ID
• Access Medical Clinic LLC

  dba Access Medical Clinic

  • Rural Health Clinic/Center
  • Crawfordsville, IN
  • NPI 1831810431

  1951721802

  Same PAC ID
• Access Medical Clinic LLC

  • Rural Health Clinic/Center
  • Valley, AL
  • NPI 1912696923

  1951721802

  Same PAC ID
• Access Medical Clinic LLC

  • Rural Health Clinic/Center
  • Big Spring, TX
  • NPI 1972294213

  1951721802

  Same PAC ID

Other NPIs on the same Medicare enrollment 4

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

• Access Medical Clinic LLC

  dba Access Medical Clinic

  • Rural Health Clinic/Center
  • Gatlinburg, TN
  • NPI 1023621646

  O20201015001357

  Same enrollment
• Access Medical Clinic LLC

  • Rural Health Clinic/Center
  • Jacksboro, TN
  • NPI 1114881117

  O20201015001357

  Same enrollment
• Access Medical Clinic LLC

  • Rural Health Clinic/Center
  • Clinton, TN
  • NPI 1215891098

  O20201015001357

  Same enrollment
• Access Medical Clinic Tennessee LLC

  • Family Medicine Physician
  • Farragut, TN
  • NPI 1518553247

  O20201015001357

  Same enrollment

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

CLIA laboratory certificates

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.

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 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.

• Mark S Hahn, DO

  • Family Medicine Physician
  • Caraway, AR
  • NPI 1609895911
  NPD

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1871191874",
    "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": "13 BOB TOLLETT LOOP",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385552835",
            "telephone_number": "931-456-6057",
            "fax_number": "873-989-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-12",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "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": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 493 Internal Medicine PLLC
• Elias Abou-Zeid, MD
• Access Medical Clinic LLC
• Acute Care Clnic Inc
• Amanda P Adams
• Advanced Rehabilitation Center, PLLC
• Advantage Therapy Services, PLLC
• Affordable-Assist Private Care

• Rural Health Clinic/Center in Crossville, TN
• Providers in Crossville, TN by specialty
• Rural Health Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.