| Boston Mountain Rural Health Center Inc | |
|
2263 Highway 65 North Marshall AR 72650-1060 | |
| (870) 448-5733 | |
| (870) 448-4769 |
| Full Name | Boston Mountain Rural Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2263 Highway 65 North, Marshall, Arkansas |
| Authorized Official Name and Position | Debbie Ackerson (CEO) |
| Authorized Official Contact | 8704485733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boston Mountain Rural Health Center Inc Po Box 1060 Marshall AR 72650-1060 Ph: (870) 448-5733 | Boston Mountain Rural Health Center Inc 2263 Highway 65 North Marshall AR 72650-1060 Ph: (870) 448-5733 |
| NPI Number | 1720096027 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 01/25/2019 |
| Medicare PECOS PAC ID | 3870401722 |
|---|---|
| Medicare Enrollment ID | O20040701000737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720096027 | NPI | - | NPPES |
| 149029749 | Medicaid | AR | |
| 150794749 | Medicaid | AR | |
| 5B477 | Other | AR | BLUE CROSS |
| 124795749 | Medicaid | AR | |
| DA1111 | Other | AR | RAILROAD MEDICARE GROUP |
| 133965749 | Medicaid | AR | |
| 135037749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Shelia Mae Howerton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922071695 PECOS PAC ID: 4183515893 Enrollment ID: I20040323000337 |
| Provider Name | Travis D Embry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750386876 PECOS PAC ID: 1153310412 Enrollment ID: I20040511000856 |
| Provider Name | Robin J Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033115001 PECOS PAC ID: 3072503697 Enrollment ID: I20040515000353 |
| Provider Name | Angela G Howard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053401497 PECOS PAC ID: 0547221202 Enrollment ID: I20041026000117 |
| Provider Name | Danny Lynn Proffitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306805379 PECOS PAC ID: 7012953524 Enrollment ID: I20050706001092 |
| Provider Name | Nicholas Piediscalzi |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1174573026 PECOS PAC ID: 4082643077 Enrollment ID: I20050810000454 |
| Provider Name | Dan B Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275583056 PECOS PAC ID: 6800868365 Enrollment ID: I20050816001192 |
| Provider Name | Lawrence Meyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386633691 PECOS PAC ID: 3173530284 Enrollment ID: I20060321000180 |
| Provider Name | Brian Blair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407846868 PECOS PAC ID: 1456458819 Enrollment ID: I20070518000224 |
| Provider Name | Carolyn R Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750585063 PECOS PAC ID: 2466481874 Enrollment ID: I20071213000188 |
| Provider Name | Lilly I Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922003169 PECOS PAC ID: 5890870968 Enrollment ID: I20080313000296 |
| Provider Name | Dawn Marie Phelps |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306048251 PECOS PAC ID: 5395822332 Enrollment ID: I20080401000818 |
| Provider Name | James Dudley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730139692 PECOS PAC ID: 2062564891 Enrollment ID: I20090709000053 |
| Provider Name | Julie A Calvery-carman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639303340 PECOS PAC ID: 1850446717 Enrollment ID: I20090831000027 |
| Provider Name | David J Geidl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871774075 PECOS PAC ID: 4789753591 Enrollment ID: I20091027000898 |
| Provider Name | Charles A Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720003247 PECOS PAC ID: 3577603513 Enrollment ID: I20091222000660 |
| Provider Name | Larkus H Pesnell |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1033193966 PECOS PAC ID: 6305971904 Enrollment ID: I20100322000558 |
| Provider Name | Thomas De Miranda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689866725 PECOS PAC ID: 4981735636 Enrollment ID: I20100624000874 |
| Provider Name | Larry B Jennings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750386553 PECOS PAC ID: 3577648609 Enrollment ID: I20100727000163 |
| Provider Name | Andrew Cole |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336111665 PECOS PAC ID: 8729276472 Enrollment ID: I20101221001103 |
| Provider Name | Ruth Ann Carpenter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033235205 PECOS PAC ID: 3476728270 Enrollment ID: I20111206000480 |
| Provider Name | Nancy S Svehla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366717316 PECOS PAC ID: 4183887367 Enrollment ID: I20120525000509 |
| Provider Name | Lauren Faulkner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710259049 PECOS PAC ID: 9234380866 Enrollment ID: I20121108000173 |
| Provider Name | Brianna C Pate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730453622 PECOS PAC ID: 4486890167 Enrollment ID: I20130425000168 |
| Provider Name | Carma L Shumake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992842785 PECOS PAC ID: 0840430740 Enrollment ID: I20130716000823 |
| Provider Name | Chrissie L Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841628161 PECOS PAC ID: 6507096567 Enrollment ID: I20140313001323 |
| Provider Name | Mandi K Strode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134517014 PECOS PAC ID: 4385968098 Enrollment ID: I20150128000618 |
| Provider Name | Katherine L Spears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326445578 PECOS PAC ID: 9739404419 Enrollment ID: I20150223000455 |
| Provider Name | Abigail A Peerce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669867503 PECOS PAC ID: 0840519062 Enrollment ID: I20150508001858 |
| Provider Name | Sylvia Irene Hathaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912191438 PECOS PAC ID: 9931274750 Enrollment ID: I20150727002550 |
| Provider Name | John N Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689061129 PECOS PAC ID: 9830403302 Enrollment ID: I20150729007510 |
| Provider Name | Paula A Stapleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720029523 PECOS PAC ID: 3870800147 Enrollment ID: I20150918001012 |
| Provider Name | Neil Langer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538530316 PECOS PAC ID: 7012213788 Enrollment ID: I20160307000198 |
| Provider Name | Patricia E Sheppard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740649920 PECOS PAC ID: 7719286442 Enrollment ID: I20160503000087 |
| Provider Name | Haleigh Trotter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982966701 PECOS PAC ID: 7719278944 Enrollment ID: I20160620001081 |
| Provider Name | Greta S Jean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902245889 PECOS PAC ID: 9436467974 Enrollment ID: I20160722001523 |
| Provider Name | Ginger L Clifton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639497134 PECOS PAC ID: 5193041903 Enrollment ID: I20170209001963 |
| Provider Name | Tessa M Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275071516 PECOS PAC ID: 2668758004 Enrollment ID: I20170419000830 |
| Provider Name | Tamra T Lamer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235494329 PECOS PAC ID: 1052550324 Enrollment ID: I20170607001058 |
| Provider Name | Justin W Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083024848 PECOS PAC ID: 9537473285 Enrollment ID: I20170628001117 |
| Provider Name | Rebekah Pevia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235441684 PECOS PAC ID: 7517237381 Enrollment ID: I20170727000590 |
| Provider Name | Carol A Piatkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679006969 PECOS PAC ID: 9739454471 Enrollment ID: I20171006000463 |
| Provider Name | Julie Marie King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629596960 PECOS PAC ID: 2365717949 Enrollment ID: I20171006002606 |
| Provider Name | Karen Elizabeth Tester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881684991 PECOS PAC ID: 8729300983 Enrollment ID: I20181203000804 |
| Provider Name | Cindy A Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831665744 PECOS PAC ID: 8325386394 Enrollment ID: I20190218000919 |
| Provider Name | Tammy L Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417286691 PECOS PAC ID: 7315287216 Enrollment ID: I20190312002324 |
| Provider Name | Toni D Myer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821574815 PECOS PAC ID: 4981946605 Enrollment ID: I20190430000861 |
| Provider Name | Angela N Teague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639726862 PECOS PAC ID: 1355774910 Enrollment ID: I20191212001100 |
| Provider Name | David S Zimmerman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346772050 PECOS PAC ID: 9537437264 Enrollment ID: I20200402003132 |
| Provider Name | Starla Lynnette Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013563493 PECOS PAC ID: 5991036071 Enrollment ID: I20200501000526 |
| Provider Name | Ashley M Tallent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780297739 PECOS PAC ID: 3274953708 Enrollment ID: I20201021001843 |
| Provider Name | Erin K Edgmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346856366 PECOS PAC ID: 1658781737 Enrollment ID: I20201030000742 |
| Provider Name | Mikka Elizabeth Fenley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821690884 PECOS PAC ID: 3779995246 Enrollment ID: I20201208001063 |
| Provider Name | Jordan I Powers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225535024 PECOS PAC ID: 6608275235 Enrollment ID: I20210601001851 |
| Provider Name | Samuel D Bentley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265002513 PECOS PAC ID: 8022419845 Enrollment ID: I20210630000983 |
| Provider Name | Carol Ann Wynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750961785 PECOS PAC ID: 1850793837 Enrollment ID: I20210713003411 |
| Provider Name | Tiffany C Saric |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265003180 PECOS PAC ID: 7517369317 Enrollment ID: I20210716000153 |
| Provider Name | Natalie Mazhambe Dinecola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669960043 PECOS PAC ID: 9739519570 Enrollment ID: I20210927002007 |
| Provider Name | Brooklyn E Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629745088 PECOS PAC ID: 2769889047 Enrollment ID: I20210929002149 |
| Provider Name | Rebecca A Palas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811334659 PECOS PAC ID: 1759770852 Enrollment ID: I20211111000050 |
| Provider Name | Sean M Palas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346785383 PECOS PAC ID: 5193068658 Enrollment ID: I20211201002199 |
| Provider Name | Amy L White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952035693 PECOS PAC ID: 5193107738 Enrollment ID: I20220729000878 |
| Provider Name | Victoria M Deal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609504430 PECOS PAC ID: 6204210305 Enrollment ID: I20220908000507 |
| Provider Name | Toynicka N Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104213842 PECOS PAC ID: 0446635734 Enrollment ID: I20220922003375 |
| Provider Name | Nytisha Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427653575 PECOS PAC ID: 6406253087 Enrollment ID: I20220926001192 |
| Provider Name | Laura A Massey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174502710 PECOS PAC ID: 0244314326 Enrollment ID: I20221108001406 |
| Provider Name | Heather Mcloud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407566755 PECOS PAC ID: 2264801182 Enrollment ID: I20221214003013 |
| Provider Name | Rollie Stewart Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003426396 PECOS PAC ID: 2860811460 Enrollment ID: I20230630000284 |
| Provider Name | Caitlin Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184317943 PECOS PAC ID: 6709245574 Enrollment ID: I20230711004110 |
| Provider Name | Amber M Brossett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578947560 PECOS PAC ID: 9234582016 Enrollment ID: I20240129000961 |
Boston Mountain Rural Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 106 Westwood Dr, Marshall, AR 72650 Phone: 870-448-3455 Fax: 870-448-3392 | |
Marshall Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 Airport Road, Marshall, AR 72650 Phone: 870-448-3328 | |
Access Medical Clinic Arkansas Ltc Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 942 Highway 65 N, Marshall, AR 72650 Phone: 888-518-1418 Fax: 870-994-2164 |