NPIMap

Organization Active NPI

Ozark Health, Inc

Doing business as Ozark Medical Clinic - Shirley

  • Rural Health Clinic/Center
  • Shirley, AR
National Provider Identifier
1891573523
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
OZARK HEALTH, INC
Doing business as
Ozark Medical Clinic - Shirley
Practice address
199 School Dr
Shirley, AR 72153-7566
Phone
(501) 723-4400
Fax
(501) 745-9741
NPI assigned
Sep 14, 2023
Last updated
Sep 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Rebecca Gentry
Title
Accounting Specialist
Phone
(501) 745-9524

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

199 School Dr
Shirley, AR 72153-7566

Mailing address

PO Box 206
Clinton, AR 72031-0206
Phone (501) 745-9524

Other names 1

  • Ozark Medical Clinic - Shirley Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040628000567 AR Part B Supplier - Clinic/Group Practice 7315923620 Receives reassigned benefits from 57 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton, AR; Fairfield Bay, AR; Shirley, AR

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Ozark Health Medical Center Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1891573523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "720310206",
            "telephone_number": "501-745-9524",
            "fax_number": "501-745-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 SCHOOL DR",
            "city": "SHIRLEY",
            "state": "AR",
            "postal_code": "721537566",
            "telephone_number": "501-723-4400",
            "fax_number": "501-745-9741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARK HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "GENTRY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "ACCOUNTING SPECIALIST",
        "authorized_official_telephone_number": "501-745-9524"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ozark Medical Clinic - Shirley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shirley, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.