NPIMap

Organization Active NPI

Boston Mountain Rural Health Center, Inc

Doing business as Boston Mountain Rural Health Center Huntsville School Based Health Center

  • Federally Qualified Health Center (FQHC)
  • Huntsville, AR
National Provider Identifier
1972313237
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
Doing business as
Boston Mountain Rural Health Center Huntsville School Based Health Center
Practice address
403 Polk St
Huntsville, AR 72740-9130
Phone
(479) 738-1583
Fax
(479) 738-1350
NPI assigned
Jan 9, 2025
Last updated
Jan 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Authorized official

Name
Debbie Ackerson
Title
Ceo
Phone
(870) 448-5733

Specialties & licenses 1

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

Addresses

Primary practice location

403 Polk St
Huntsville, AR 72740-9130

Mailing address

PO Box 1060
Marshall, AR 72650-1060
Phone (870) 448-5101

Other names 1

  • Boston Mountain Rural Health Center Huntsville School Based Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250401003562 AR Part A Provider - Federally Qualified Health Center (FQHC) 3870401722 Practice locations: Huntsville, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972313237. Details of each certification follow.

Federally qualified health center certification: CCN 041081

Legal name
BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
Doing business as
BMRHC HUNTSVILLE SCHOOL BASED HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 12, 2025
Last certification
Mar 12, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
403 Polk St
Huntsville, AR 72740-9130

Other NPIs with the same Medicare PAC ID 19

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

View all 19

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
04D2317302Boston MTN Rural Health Center Inc - HV SBHC403 Polk St, Huntsville, AR 72740Certificate of waiverJan 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
Boston Mountain Rural H25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

1125 Skyline Dr
Conway, AR 72032
Phone (501) 358-6120

4004 E Van Buren
Eureka Springs, AR 72632
Phone (479) 363-6196

403 Polk St
Huntsville, AR 72740
Phone (479) 738-1583

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Mary Lynn Emmett Individual Corporate OfficerBoard Member Jan 1, 2004
Debbie Ackerson Individual Corporate OfficerCeo Jun 5, 2017
Christopher Graham Individual Corporate OfficerBoard Member Jan 1, 1999
Donna Samples Individual Corporate OfficerBoard Chairman Jan 1, 2003
Rebecca Blair Individual Corporate OfficerCfo Dec 16, 2013
W-2 Managing EmployeeCfo Dec 16, 2013

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Boston Mountain Rural Health Center, IncMarshall, AR, CCN 041984 Federally qualified health center Other Mar 14, 1994

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 50

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 50

NPI Registry JSON

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1972313237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1060",
            "city": "MARSHALL",
            "state": "AR",
            "postal_code": "726501060",
            "telephone_number": "870-448-5101",
            "fax_number": "870-448-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 POLK ST",
            "city": "HUNTSVILLE",
            "state": "AR",
            "postal_code": "727409130",
            "telephone_number": "479-738-1583",
            "fax_number": "479-738-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON MOUNTAIN RURAL HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "ACKERSON",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-448-5733"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boston Mountain Rural Health Center Huntsville School Based Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntsville, AR

Sources for this page

Verify at the official NPI Registry.