Mainline Health Systems, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MAINLINE HEALTH SYSTEMS, INC

Doing business as

Mainline Health Magnolia Clinic

Practice address

1617 N Washington St Ste 1
Magnolia, AR 71753-2046

Phone

(501) 451-4110

NPI assigned

Nov 24, 2025

Last updated

May 15, 2026By 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

Elyse Knobloch

Title

Chief Financial Officer

Phone

(870) 538-5412

Specialties & licenses 2

Addresses

Other names 1

• MAINLINE HEALTH MAGNOLIA CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972464337. Details of each certification follow.

• CCN 041093 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 041093

Legal name

MAINLINE HEALTH SYSTEMS INC

Doing business as

MAINLINE HEALTH MAGNOLIA CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Dec 24, 2025

Last certification

Dec 24, 2025

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

1617 N Washington
Ste 1
Magnolia, AR 71753-2046

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

CLIA laboratory certificates

Tax ID family

Sanyasi R Ganta MD36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

• Mainline Health Systems Inc

  dba Sheridan Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Sheridan, AR
  • NPI 1104574219
  NPD tax ID
• Mainline Health Systems Inc

  dba Monticello Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Monticello, AR
  • NPI 1205163540
  NPD tax ID
• Mainline Health Systems Inc

  dba Warren High School Behavioral Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Warren, AR
  • NPI 1215700265
  NPD tax ID
• Mainline Health Systems Inc

  dba Portland Health Care

  • Federally Qualified Health Center (FQHC)
  • Portland, AR
  • NPI 1316106388
  NPD tax ID
• Mainline Health Systems Inc

  dba Mainline UAM Behavioral Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Monticello, AR
  • NPI 1326717745
  NPD tax ID
• Mainline Health Systems Inc

  dba Mainline Health Systems, Inc- Warren 2

  • Federally Qualified Health Center (FQHC)
  • Warren, AR
  • NPI 1396383758
  NPD tax ID
• Mainline Health Systems Inc

  dba Star City Community Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Star City, AR
  • NPI 1649679051
  NPD tax ID
• Mainline Health Systems Inc

  dba Mainline UAM Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Monticello, AR
  • NPI 1861156481
  NPD tax ID
• Mainline Health Systems Inc

  dba Wilmot DRS Clinic

  • Federally Qualified Health Center (FQHC)
  • Wilmot, AR
  • NPI 1891809547
  NPD tax ID
• Mainline Health Systems, Inc

  dba Hamburg High School

  • Federally Qualified Health Center (FQHC)
  • Hamburg, AR
  • NPI 1033584586
  NPD tax ID
• Mainline Health Systems, Inc

  dba Jimmy Brown Elementary

  • Federally Qualified Health Center (FQHC)
  • Star City, AR
  • NPI 1124565213
  NPD tax ID
• Mainline Health Systems, Inc

  dba Star City Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Star City, AR
  • NPI 1154757920
  NPD tax ID

Locations

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.

All facility ownership & control disclosures 26

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

Practitioners 68

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.

• Meredith B Allison, ANP

  • Nurse Practitioner
  • Pine Bluff, AR
  • NPI 1619275070
  NPD
• Rebekah Ayecock, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dermott, AR
  • NPI 1104251180
  NPD
• John Austin Beatty, MD

  • Family Medicine Physician
  • Warren, AR
  • NPI 1578050472
  NPD
• Blayne Ellis Beene, DO

  • Family Medicine Physician
  • Sheridan, AR
  • NPI 1528552130
  NPD
• Jesse Bone, CNP

  • Family Nurse Practitioner
  • Monticello, AR
  • NPI 1770039752
  NPD
• Debbie Clark, LPC

  • Mental Health Counselor
  • Little Rock, AR
  • NPI 1669056305
  NPD
• Jennifer Cotton, CASE MANAGER

  • Clinical Social Worker
  • Monticello, AR
  • NPI 1811024276
  NPD
• Charlie J Cruce

  • Family Nurse Practitioner
  • Dermott, AR
  • NPI 1962044800
  NPD
• Kristen Dent, M.D.

  • Family Medicine Physician
  • Monticello, AR
  • NPI 1881072791
  NPD
• Terri Ann Eubanks, DDS

  • General Practice Dentistry
  • Dermott, AR
  • NPI 1306960737
  NPD
• Myra Brooke Flemister, APRN

  • Primary Care Nurse Practitioner
  • Portland, AR
  • NPI 1982128096
  NPD
• Skylar Michelle Garner, DDS

  • General Practice Dentistry
  • Star City, AR
  • NPI 1225568363
  NPD

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

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778803200000",
    "number": "1972464337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 HIGHWAY 425 S",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554612",
            "telephone_number": "870-942-3000",
            "fax_number": "870-942-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 N WASHINGTON ST STE 1",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532046",
            "telephone_number": "501-451-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINLINE HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-24",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A",
        "authorized_official_last_name": "KNOBLOCH",
        "authorized_official_first_name": "ELYSE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "870-538-5412"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAINLINE HEALTH MAGNOLIA CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Magnolia Regional Medical Center
• Magnolia School District 14 (Magnolia Public Schools)
• Magnolia Specialized Services, Inc.
• Magnolia Surgery Center, LLC
• Mainline Health Systems, Inc (Mainline Health Magnolia Family Health Center)
• Jeremy Jini Malone
• Sandra K Manning, MHPP
• Gregory Lynn Martin, D.D.S.
• Sheila K Martin, COTA/L
• Brandy Vanell Martisek, NP

• Federally Qualified Health Center (FQHC) in Magnolia, AR
• Providers in Magnolia, AR by specialty
• Federally Qualified Health Center (FQHC) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; 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.