CHICOT MEMORIAL MEDICAL CENTER (NPI# 1821313313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821313313 |
| Entity Type | Organization |
| Organization Name | CHICOT MEMORIAL MEDICAL CENTER |
| Practice Address |
2729 Hwy 65 & 82 S Lake Village AR 71653-6136 |
| Practice Telephone | 8702655351 |
| Practice Fax Number | 8702652091 |
| Mailing Telephone | 8702655351 |
| Mailing Fax Number | 8702652091 |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2015-06-30 |
| Authorized Official Name | SUSAN VAUGHN (CFO) |
| Authorized Official Telephone | 8702655351 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHICOT MEMORIAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 275N00000X | Medicare Defined Swing Bed Unit | AR4386 | AR | Hospital Units |
| Y | 275N00000X | Medicare Defined Swing Bed Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 181080105 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861901985 | Chicot Memorial Medical Center | Clinic/Center | 2729 S. Hwy 65 82, Lake Village, AR 71653 | 2017-09-20 |
| 1235453192 | Chicot Memorial Medical Center | General Acute Care Hospital | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-22 |
| 1003213281 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-12-03 |
| 1841602810 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-05-27 |
| 1104238179 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-05-27 |
| 1568787059 | Chicot Memorial Medical Center | Home Health | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| 1902121494 | Chicot Memorial Medical Center | Emergency Medicine | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| 1457676942 | Chicot Memorial Medical Center | Nurse Anesthetist, Certified Registered | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| Street Address |
2729 HWY 65 & 82 S |
| City | LAKE VILLAGE |
| State | AR |
| Zip Code | 71653-6136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235453192 | Chicot Memorial Medical Center | General Acute Care Hospital | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-22 |
| 1003213281 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-12-03 |
| 1841602810 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-05-27 |
| 1104238179 | Chicot Memorial Medical Center | Clinic/Center | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2014-05-27 |
| 1568787059 | Chicot Memorial Medical Center | Home Health | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| 1902121494 | Chicot Memorial Medical Center | Emergency Medicine | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| 1457676942 | Chicot Memorial Medical Center | Nurse Anesthetist, Certified Registered | 2729 Hwy 65 & 82 S, Lake Village, AR 71653-6136 | 2010-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811500192 | Ashley Brown | Speech-Language Pathologist | 336 Us-82, Lake Village, AR 71653 | 2020-08-26 |
| 1861901985 | Chicot Memorial Medical Center | Clinic/Center | 2729 S. Hwy 65 82, Lake Village, AR 71653 | 2017-09-20 |
| 1326586173 | Mainline Health Systems, Inc | Clinic/Center | 360 A Hwy 82, Lake Village, AR 71653 | 2017-02-01 |
| 1508303124 | Mainline Health Systems, Inc | Clinic/Center | 360 A Highway 82, Lake Village, AR 71653 | 2017-01-20 |
| 1689120263 | Russell Medical Services Pllc | Family Medicine | 5071 Highway 82 E, Lake Village, AR 71653 | 2016-09-01 |
| 1528362035 | Hillman Chiropractic LLC | Chiropractor | 2819 Louis Sessions Dr., Lake Village, AR 71653 | 2010-12-28 |
| 1902113913 | Sheri K Bagwell | Counselor | 1127 Second St., Lake Village, AR 71653 | 2010-09-13 |
| 1205154044 | Arkansas Department of Health | Public Health or Welfare | 1742 Hwy 65 and 82 South, Lake Village, AR 71653 | 2010-05-04 |
| 1114259041 | William Jackson Weaver | General Practice | 1754 Lake Hall Road, Lake Village, AR 71653 | 2010-02-03 |
| 1821246992 | Maurenella Antionette Nelson | Social Worker | 1127 Second Street, Lake Village, AR 71653 | 2008-09-03 |
| Find all providers in zip 71653 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932395969 | City of Pocahontas Ar | Medicare Defined Swing Bed Unit | 2801 Medical Center Drive, Pocahontas, AR 72455-9436 | 2007-09-24 |
| 1992865513 | Ozark Health, Inc | Medicare Defined Swing Bed Unit | 2500 Hwy 65 South, Clinton, AR 72031 | 2006-12-12 |
| 1598842643 | Booneville Community Hospital, Inc | Medicare Defined Swing Bed Unit | 880 West Main, Booneville, AR 72927-0290 | 2006-11-01 |
| 1609811827 | Baptist Health | Medicare Defined Swing Bed Unit | 1800 Bypass Road, Heber Springs, AR 72543 | 2006-06-19 |
| 1881635993 | Izard County Medical Center, LLC | Medicare Defined Swing Bed Unit | 61 Grasse St, Calico Rock, AR 72519-0438 | 2006-06-09 |
| 1902862915 | White River Health System, Inc | Medicare Defined Swing Bed Unit | 2106 E. Main St., Mountain View, AR 72560-6439 | 2006-04-26 |
| 1093336026 | Magnolia Regional Health System Inc | Medicare Defined Swing Bed Unit | 101 Hospital Dr, Magnolia, AR 71753-2415 | 2020-04-30 |
| 1538796651 | Eureka Springs Hospital Commission | Medicare Defined Swing Bed Unit | 24 Norris St, Eureka Springs, AR 72632-3541 | 2020-03-26 |
| 1407369390 | Siloam Springs Arkansas Hospital Company LLC | Medicare Defined Swing Bed Unit | 603 N Progress Ave, Siloam Springs, AR 72761-4352 | 2017-11-14 |
| 1649724261 | Baptist Health | Medicare Defined Swing Bed Unit | 1001 Schneider Dr, Malvern, AR 72104-4811 | 2016-08-11 |
| Find all providers with the same taxonomy | ||||
| City | LAKE VILLAGE |
| Zip Code | 71653 |
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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.