MONTICELLO MEDICAL CLINIC PLC (NPI# 1366422305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366422305 |
| Entity Type | Organization |
| Organization Name | MONTICELLO MEDICAL CLINIC PLC |
| Practice Address |
906 Roberts Dr Monticello AR 71655-5724 |
| Practice Telephone | 8703676867 |
| Practice Fax Number | 8703671461 |
| Mailing Telephone | 8703676867 |
| Mailing Fax Number | 8703671461 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2020-04-01 |
| Authorized Official Name | SYLVIA SIMON (PARTNER) |
| Authorized Official Telephone | 8703676867 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 139812002 | 05 | |
| AR | BREASTCARE | 77067202 | 01 |
| Street Address |
906 ROBERTS DR |
| City | MONTICELLO |
| State | AR |
| Zip Code | 71655-5724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649250689 | Jay Ross Connelley | Family Medicine | 906 Roberts Dr, Monticello, AR 71655-5724 | 2006-01-17 |
| 1770020521 | Anthony Rodriguez | Nurse Practitioner | 906 Roberts Dr, Monticello, AR 71655-5724 | 2017-01-31 |
| 1336534411 | Katelyn Halie Carmical | Family Medicine | 906 Roberts Dr, Monticello, AR 71655-5724 | 2015-04-06 |
| 1285977843 | James Roy Atkins Jr. | Pediatrics | 906 Roberts Dr, Monticello, AR 71655-5724 | 2013-04-02 |
| 1356649412 | Amanda Kaye Bickford | Nurse Practitioner | 906 Roberts Dr, Monticello, AR 71655-5724 | 2011-03-14 |
| 1871642215 | Jefferson Management Services Inc | Clinic/Center | 906 Roberts Dr, Monticello, AR 71655-5724 | 2007-01-08 |
| 1225148315 | Joseph Michael Fakouri Jr. | Family Medicine | 906 Roberts Dr, Monticello, AR 71655-5724 | 2006-08-30 |
| 1376523316 | Timothy M Simon | Family Medicine | 906 Roberts Dr, Monticello, AR 71655-5724 | 2006-01-17 |
| 1639159676 | Sylvia Simon | Family Medicine | 906 Roberts Dr, Monticello, AR 71655-5724 | 2006-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104462712 | Ashley Leanna Huitt | Nurse Practitioner | Drew Memorial Health System, 778 Scogin Drive, Monticello, AR 71655 | 2019-11-19 |
| 1043716525 | Mmc Rural Health Clinics, Pllc | Clinic/Center | 733 Roberts Drive, Monticello, AR 71655 | 2018-04-03 |
| 1760991640 | Kristen Leigh Harvey | Registered Nurse | 162 University Heights Drive, Monticello, AR 71655 | 2017-09-24 |
| 1124578075 | Morgan Family Dentistry, Pllc | Dentist | 501 Hwy 425 South, Monticello, AR 71655 | 2016-10-04 |
| 1770039752 | Jesse Bone | Nurse Practitioner | 766 Hl Ross Drive, Monticello, AR 71655 | 2016-08-30 |
| 1487050076 | Sara Tucker | Speech-Language Pathologist | 178 W. College Street, Monticello, AR 71655 | 2014-11-10 |
| 1164859203 | Dustin Clint Eubanks | Chiropractor | 604 A West Bolling Street, Monticello, AR 71655 | 2013-10-03 |
| 1194009431 | Rebecca Shea Woodall | Social Worker | 600 Highway 425 North, Suite B, Monticello, AR 71655 | 2011-10-05 |
| 1568744522 | Britney Leigh Box | Occupational Therapist | 178 W College St, Monticello, AR 71655 | 2011-09-15 |
| 1740415611 | Julia Danielle Nicholson | Family Medicine | 906 Roberts Drive, Monticello, AR 71655 | 2009-05-21 |
| Find all providers in zip 71655 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508251786 | Grand Manor | Clinic/Center | 1960 Highway 425 N, Monticello, AR 71655-8862 | 2015-04-03 |
| 1841453271 | Studer Chiropractic, P.C. | Clinic/Center | 113 Locust St, Monticello, MN 55362-8849 | 2008-07-07 |
| 1770519100 | Mckiever Clinic | Clinic/Center | 766 H L Ross Dr, Monticello, AR 71655-5706 | 2006-06-25 |
| 1306192695 | Horizon Chiropractic LLC | Clinic/Center | 920 W Broadway St, Monticello, IN 47960-1814 | 2012-07-24 |
| 1366705113 | Adams Enterprises of East Central Illinois PC | Clinic/Center | 1109 N State St, Monticello, IL 61856-1175 | 2012-06-18 |
| 1114291879 | Foothills Academy, Inc. | Clinic/Center | 80 Rolling Hills Blvd, Monticello, KY 42633-9005 | 2012-02-28 |
| 1710113071 | Reinhart Family Healthcare Pllc | Clinic/Center | 777 Jordan Dr, Monticello, AR 71655-5719 | 2009-06-01 |
| 1669591053 | Jefferson Management Services Inc | Clinic/Center | 750 H L Ross Dr, Monticello, AR 71655-5705 | 2007-03-28 |
| 1669590113 | Jefferson Management Service Inc | Clinic/Center | 750 H L Ross Dr, Monticello, AR 71655-5705 | 2007-03-26 |
| 1841318334 | Jefferson Management Services | Clinic/Center | 777 Jordan Dr, Monticello, AR 71655-5719 | 2007-03-26 |
| Find all providers in MONTICELLO | ||||
| City | MONTICELLO |
| Zip Code | 71655 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.