MAINLINE HEALTH SYSTEMS, INC (NPI# 1417064890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417064890 |
| Entity Type | Organization |
| Organization Name | MAINLINE HEALTH SYSTEMS, INC |
| Other Organization Name | MAINLINE DERMOTT DENTAL CLINIC |
| Practice Address |
300 S School St Dermott AR 71638-2127 |
| Mailing Address |
Po Box 509 Dermott AR 71638-0509 |
| Practice Telephone | 8705389720 |
| Practice Fax Number | 8705389701 |
| Mailing Telephone | 8705385414 |
| Mailing Fax Number | 8705385412 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2018-11-19 |
| Authorized Official Name | GARY ALLAN NICHOLS (CEO) |
| Authorized Official Telephone | 8705385414 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 152991631 | 05 |
| Other Name | Type Code |
|---|---|
| MAINLINE DERMOTT DENTAL CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659890150 | Mainline Health Systems, Inc | Clinic/Center | 250 University Dr, Monticello, AR 71655-8891 | 2017-09-15 |
| 1326586173 | Mainline Health Systems, Inc | Clinic/Center | 360 A Hwy 82, Lake Village, AR 71653 | 2017-02-01 |
| 1619415460 | Mainline Health Systems, Inc | Clinic/Center | 566 S Mabry St, Eudora, AR 71640-2941 | 2017-02-01 |
| 1124565213 | Mainline Health Systems, Inc | Clinic/Center | 310 Ashley St, Star City, AR 71667 | 2017-01-26 |
| 1508303124 | Mainline Health Systems, Inc | Clinic/Center | 360 A Highway 82, Lake Village, AR 71653 | 2017-01-20 |
| 1891245809 | Mainline Health Systems, Inc | Clinic/Center | 525 E Speedway St, Dermott, AR 71638-2322 | 2016-10-13 |
| 1649636986 | Mainline Health Systems, Inc | Clinic/Center | 314 Highway 160 E, Portland, AR 71663-9262 | 2015-12-31 |
| 1790140564 | Mainline Health Systems, Inc | Clinic/Center | 2764 Hwy 165 S, Wilmot, AR 71676 | 2015-12-22 |
| 1962518795 | Mainline Health Systems, Inc | Clinic/Center | 127 Hickory St, Fountain Hill, AR 71642 | 2006-08-22 |
| 1619082724 | Mainline Health Systems, Inc | Clinic/Center | 579 E Beouff St, Eudora, AR 71640-3090 | 2006-08-20 |
| Street Address |
300 S SCHOOL ST |
| City | DERMOTT |
| State | AR |
| Zip Code | 71638-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386758043 | Mainline Health Systems Inc | Clinic/Center | 300 S School St, Dermott, AR 71638-2228 | 2006-08-19 |
| 1962044800 | Charlie J Gober | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2019-10-11 |
| 1710448535 | Clark N Roberts | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2019-03-26 |
| 1205315637 | Kimberly Weeks | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2018-08-07 |
| 1184102303 | William Joshua Hunter | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2018-07-31 |
| 1104361880 | Tiffany Wargo | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2017-01-04 |
| 1386026359 | Courtney Shay Johnson | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2015-06-25 |
| 1669886552 | Shenika Jackson-king | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2014-06-18 |
| 1821409996 | Crystal Little | Pediatrics | 300 S School St, Dermott, AR 71638-2127 | 2014-05-12 |
| 1659710879 | Dana Shea Phillips | Nurse Practitioner | 300 S School St, Dermott, AR 71638-2127 | 2013-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104251180 | Rebekah Ayecock | Nurse Practitioner | 300 South School St, Dermott, AR 71638 | 2013-09-09 |
| 1508198201 | Roger Alan Mason | Surgery | 300 South School St., Dermott, AR 71638 | 2010-02-04 |
| 1730219353 | Dermott Day Service Center, Inc. | Day Training, Developmentally Disabled Services | 817 North School Street, Dermott, AR 71638 | 2007-03-06 |
| 1134286750 | Dermott City Nursing Home | Skilled Nursing Facility | 702 West Gaines St., Dermott, AR 71638 | 2007-01-02 |
| 1861555005 | Dermott High School | Local Education Agency (LEA) | 525 East Speedway, Dermott, AR 71638 | 2006-12-19 |
| 1811095656 | Phillip W Pennington | Dentist | 300 S School, Dermott, AR 71638 | 2006-09-20 |
| 1669401501 | Mainline Health Systems, Inc | Clinic/Center | 134 South Strickland St, Dermott, AR 71638 | 2006-07-02 |
| 1982643409 | Jeffery Fenton Dunn Sr. | Pharmacist | 111 E Peddicord Street, Dermott, AR 71638 | 2006-06-06 |
| 1609298306 | Cb King Jm | Day Training, Developmentally Disabled Services | 1109 North School, Dermott, AR 71638-0000 | 2014-01-15 |
| 1780119610 | Medical Transport Management, Inc | Ambulance | 109 W Peddicord St, Dermott, AR 71638-2115 | 2017-04-28 |
| Find all providers in zip 71638 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891245809 | Mainline Health Systems, Inc | Clinic/Center | 525 E Speedway St, Dermott, AR 71638-2322 | 2016-10-13 |
| 1801288014 | Marvin D. Loyd, Dds | Clinic/Center | 880 E Gaines St, Dermott, AR 71638-9609 | 2015-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557539 | David M Robbins Dds | Clinic/Center | 241 Hobson Ave, Hot Springs, AR 71913-3724 | 2020-10-28 |
| 1710585856 | Frank A Brooks IIi Dds Pa | Clinic/Center | 2102 First National Dr, Harrison, AR 72601-6234 | 2020-10-12 |
| 1902412018 | Cave Springs Dental | Clinic/Center | 260 S Gleneagle Dr Ste C, Cave Springs, AR 72718-6011 | 2020-09-23 |
| 1134733876 | Bradley R Crossfield Dds Pllc | Clinic/Center | 880 East Centerton Blvd, Suite A, Centerton, AR 72719 | 2020-09-01 |
| 1275143950 | Brad Wheelis Family Dentistry Pllc | Clinic/Center | 1218 East Main St, Melbourne, AR 72556 | 2020-08-06 |
| 1962012385 | Cynthia Landry Dds | Clinic/Center | 446 Miles St, Lepanto, AR 72354-2618 | 2020-08-01 |
| 1548878077 | Douglas M. Matthews,d.d.s.,p.a. | Clinic/Center | 350 E College St, Batesville, AR 72501-5624 | 2020-07-21 |
| 1407473481 | Simon Family Dentistry | Clinic/Center | 191 Highway 64 E, Alma, AR 72921-3306 | 2020-06-25 |
| 1912529504 | Dover Dental D.d.s., P.a. Dba Dover Family Dentistry | Clinic/Center | 400 S College St Ste 4, Mountain Home, AR 72653-3991 | 2020-05-18 |
| 1548881550 | Christi Weaver Shepard Dds, Pa | Clinic/Center | 4200 N Rodney Parham Rd Ste 200, Little Rock, AR 72212-2460 | 2020-04-30 |
| Find all providers with the same taxonomy | ||||
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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.