NPIMap

Organization Active NPI

1St Choice Healthcare Inc

Doing business as 1st Choice Healthcare

  • Federally Qualified Health Center (FQHC)
  • Highland, AR
National Provider Identifier
1962824672
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
1ST CHOICE HEALTHCARE INC
Doing business as
1st Choice Healthcare
Practice address
2178 Highway 62 412
Highland, AR 72542-9478
Phone
(870) 994-2202
Fax
(870) 994-2328
NPI assigned
Jan 15, 2014
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Sydney Stevens
Title
Chief Operating Officer
Phone
(870) 857-3334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2178 Highway 62 412
Highland, AR 72542-9478

Mailing address

PO Box 83
Corning, AR 72422-0083
Phone (870) 857-3334

Other practice location 1

308 Highway 62 W
Ash Flat, AR 72513-9415
Phone (870) 994-2202

Other names 1

  • 1st Choice Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100427000059 AR Part B Supplier - Clinic/Group Practice 0648184218 Receives reassigned benefits from 41 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Walnut Ridge, AR; Salem, AR; Pocahontas, AR; Highland, AR; Paragould, AR; Corning, AR
O20140325000766 AR Part A Provider - Federally Qualified Health Center (FQHC) 0648184218 Practice locations: Highland, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962824672. Details of each certification follow.

Federally qualified health center certification: CCN 041895

Legal name
1ST CHOICE HEALTHCARE INC
Doing business as
1ST CHOICE HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 22, 2014
Last certification
Apr 22, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 3, 1992 in AR
Enrollment address
2178 Highway 62 412
Highland, AR 72542-9478

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
George Hobby7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

2178 Highway 62 412
Highland, AR 72542
Phone (870) 994-2202

201 Colonial Dr
Walnut Ridge, AR 72476
Phone (870) 886-5507

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Freda Adams Individual W-2 Managing EmployeeProvider Credentialing Coordinator Sep 5, 2023
Paul Carr Individual Corporate DirectorBoard Member Jul 1, 2024
Patricia Patterson Individual Corporate DirectorBoard Member Jul 1, 2024
Greg Mock Individual Corporate DirectorBoard Member Jul 1, 2021
Diana Dalton Individual Corporate DirectorBoard Member Jan 1, 2025
Randy Goodman Individual Corporate DirectorBoard Member Jul 1, 2024
Pat Johnson Individual Corporate DirectorBoard Member Jul 1, 2025
Brenda Poindexter Individual Corporate DirectorBoard Member Jul 1, 2024
Josh Gooch Individual Corporate DirectorBoard Member Jul 1, 2021
Sydney Stevens Individual Corporate OfficerCoo Oct 31, 2022
W-2 Managing EmployeeCoo Oct 31, 2022
Operational/Managerial ControlCoo Oct 31, 2022
Joey Radcliff Individual Corporate DirectorCfo May 28, 2018
W-2 Managing EmployeeCfo May 28, 2018
Jerry Phillips Individual Corporate DirectorBoard Member Jul 1, 2021
Joie Saienni Individual Corporate DirectorBoard Member Jul 1, 2021
Bonnie White Individual Corporate OfficerBoard Chair Jul 1, 2017
Nick Manatt Individual Corporate DirectorBoard Member Jul 1, 2021
Brigitte McDonald Individual Corporate OfficerCeo Mar 1, 1997
W-2 Managing EmployeeCeo Mar 1, 1997
Operational/Managerial ControlCeo Mar 1, 1997
Larry Lawrence Individual Corporate DirectorBoard Member Jul 1, 2021

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
1St Choice Healthcare IncParagould, AR, CCN 041908 Federally qualified health center Operational/Managerial Control Jun 20, 1996
1St Choice Healthcare IncSalem, AR, CCN 041928 Federally qualified health center Operational/Managerial Control Apr 17, 2017

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 12

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": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1962824672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 83",
            "city": "CORNING",
            "state": "AR",
            "postal_code": "724220083",
            "telephone_number": "870-857-3334",
            "fax_number": "870-857-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2178 HIGHWAY 62 412",
            "city": "HIGHLAND",
            "state": "AR",
            "postal_code": "725429478",
            "telephone_number": "870-994-2202",
            "fax_number": "870-994-2328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Highway 62 W",
            "address_purpose": "LOCATION",
            "city": "Ash Flat",
            "state": "AR",
            "postal_code": "725139415",
            "country_code": "US",
            "telephone_number": "870-994-2202",
            "fax_number": "870-994-2328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "1ST CHOICE HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "SYDNEY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "870-857-3334"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1st Choice Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "1st Choice Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Highland, AR

Sources for this page

Verify at the official NPI Registry.