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CHICOT MEMORIAL MEDICAL CENTER
NPI 1003213281
Clinic/Center - Rural Health in Lake Village, AR

Active since December 03, 2014CLIA Certified · 2 labs
2729 HWY 65 & 82 S, LAKE VILLAGE, AR 71653(870) 265-5351(870) 265-2091 Get Directions Write a Review

NPPES record last updated: April 13, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Chicot Memorial Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHICOT MEMORIAL MEDICAL CENTER (NPI 1003213281) is a healthcare organization registered as a rural health in Lake Village, Arkansas and active in the NPI registry since December 2014. The organization holds 2 active CLIA laboratory certificates and lists Susan Vaughn, Cfo, as its authorized official.

NPPES Registry Identity

NPI1003213281
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameCHICOT MEMORIAL MEDICAL CENTER
Location Address2729 HWY 65 & 82 SLake Village, AR 71653-6136
Mailing Address2729 Hwy 65 & 82 SLake Village, AR 71653-6136 · (870) 265-5351 · Fax (870) 265-2091
Phone(870) 265-5351
Fax(870) 265-2091
Organization SubpartNo
Authorized OfficialSusan VaughnCfo · (870) 265-5351
Enumeration DateDecember 3, 2014
Last NPPES UpdateApril 13, 2018
✔ NPI 1003213281 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
2729 HWY 65 & 82 S, Lake Village, AR 71653
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Other Identifiers 3

Other04-1328Medicare Provider Number
Medicaid181080105AR
Other04-Z328Medicare Provider Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D0681352

Chicot Memorial Medical Center Home Health · Lake Village, AR
Active · expires Aug 31, 2026
CLIA Number04D0681352
Laboratory TypeHome Health Agency
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJames C. Wright
Laboratory Phone(870) 265-5351
Laboratory LocationChicot Memorial Medical Center Home Health2729 South Highway 65 & 82, Lake Village, AR 71653
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 04D0465387

Chicot Memorial Medical Center · Lake Village, AR
Active · expires Apr 7, 2027
CLIA Number04D0465387
Laboratory TypeHospital
Certificate Effective DateApril 8, 2025
Certificate Expiration DateApril 7, 2027
Laboratory DirectorDr. Philip J. Mingola
Laboratory Phone(870) 265-9284
Laboratory LocationChicot Memorial Medical Center2729 S Hwy 65 & 82, Lake Village, AR 71653
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHICOT MEMORIAL MEDICAL CENTER
Clinic/Center
2729 HWY 65 & 82 S
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5351
CHICOT MEMORIAL MEDICAL CENTER
General Acute Care Hospital (Critical Access)
2729 HWY 65 & 82 S
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5351
CHICOT MEMORIAL MEDICAL CENTER
Nurse Anesthetist, Certified Registered
2729 HWY 65 & 82 S
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5351
CHICOT MEMORIAL MEDICAL CENTER
Home Health
2729 HWY 65 & 82 S
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5351
CHICOT MEMORIAL MEDICAL CENTER
Medicare Defined Swing Bed Unit
2729 HWY 65 & 82 S
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5351
CHICOT MEMORIAL MEDICAL CENTER
Clinic/Center
2729 HWY 65 & 82 S
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5351
CHICOT MEMORIAL MEDICAL CENTER
Emergency Medicine
2729 HWY 65 & 82 S
LAKE VILLAGE, AR 71653
Chicot County (870) 265-5351

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Chicot Memorial Medical Center's NPI number?

The NPI number for Chicot Memorial Medical Center is 1003213281. It was assigned to this organization in the NPPES registry on December 3, 2014.

Where is Chicot Memorial Medical Center located?

Chicot Memorial Medical Center is located at 2729 Hwy 65 & 82 S, Lake Village, AR 71653. The listed phone number is (870) 265-5351.

What is Chicot Memorial Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Chicot Memorial Medical Center hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Chicot Memorial Medical Center accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Chicot Memorial Medical Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Chicot Memorial Medical Center was last updated on April 13, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.