Cabun Rural Health Services, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Hampton, AR

NPI 1912946807 · NPPES record last updated Aug 24, 2026

Key facts

NPI
1912946807
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
CABUN RURAL HEALTH SERVICES, INC.
Practice address
402 Lee St
Hampton, AR 71744-8937
Phone
(870) 798-4299
Fax
(870) 798-4100
NPI assigned
Jun 6, 2006
Organization subpart
No

Authorized official

Name
Susan Diane Johnston, LPN LRT RMC
Title
Billing Supervisor
Phone
(870) 798-3515

Other NPIs on the same Medicare enrollment 5

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

Other NPIs with the same Medicare PAC ID 5

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

Corporate family (same tax ID) 8

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

Practitioners 16

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in AR

Federally qualified health center certification: CCN 041824

Legal name
CABUN RURAL HEALTH SERVICES, INC
Doing business as
CABUN CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Jan 1, 1978 in AR
Enrollment address
402 S Lee Street
Hampton, AR 71744-1196

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jeanne D Bender
Individual
Corporate Director
Board Member
Apr 1, 2009
Shirley F Strickland
Individual
Corporate Officer
Cfo
Aug 1, 2002
Corporate Director
Board Member
May 27, 2014
W-2 Managing Employee
Ceo
Aug 1, 2002
Melanie J Sheppard
Individual
Corporate Officer
Ceo
Apr 1, 2009
Operational/Managerial Control
Ceo
Oct 17, 2016
Susan D Johnston
Individual
Corporate Officer
Cio
Oct 1, 2009
W-2 Managing Employee
Cio
Oct 1, 2009
Operational/Managerial Control
Cio
Oct 17, 2016
James C Rawls
Individual
Corporate Director
Board - Chair
Nov 30, 2009
Sandra J Gaskin
Individual
Corporate Director
Board Member
Apr 1, 1995
Tracy L Madlock
Individual
Corporate Officer
Coo
Oct 17, 2016
W-2 Managing Employee
Coo
Oct 17, 2016
Operational/Managerial Control
Coo
Oct 17, 2016
Kristie a May
Individual
Corporate Director
Board Member
Oct 1, 2002
Lenora a Davidson-McGoogan
Individual
Corporate Director
Board Member
Sep 1, 2005
Donald R Cain
Individual
Corporate Director
Board Member
Apr 1, 1999
Travis J McNiel
Individual
Corporate Director
Board Member
Apr 1, 2011
Lillie M Randall
Individual
Corporate Director
Board - Vice Chair
Apr 1, 1995

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040113000620 AR Part B Supplier - Clinic/Group Practice 9133029234 Receives reassigned benefits from 11 practitioners
5 other NPIs on this enrollment
Practice locations: Hampton, AR; Strong, AR; Lewisville, AR; Hope, AR; Bearden, AR; Amity, AR
O20111215000464 AR Part a Provider - Federally Qualified Health Center (FQHC) 9133029234 Practice locations: Hampton, AR

National Provider Directory

Tax ID family
Cabun Clinic (9 organizations share this tax ID)

Locations

601 Martin Luther King Ave
El Dorado, AR 71730
Phone (501) 529-3799

205 Smith Rd
Ste D
Hope, AR 71801
Phone (870) 777-8420

200 E 18th St
Hope, AR 71801
Phone (870) 722-2733

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

402 Lee St
Hampton, AR 71744-8937

Mailing address

PO Box 851
Hampton, AR 71744-0851
Phone (870) 798-4299

Other identifiers

IdentifierTypeStateIssuer
117567749MedicaidAR

Other providers in Hampton, AR

All providers in Hampton, AR · Federally Qualified Health Center (FQHC) in Arkansas

Sources for this page

Verify at the official NPI Registry.