CHICOT MEMORIAL MEDICAL CENTER
NPI 1003213281
Clinic/Center - Rural Health in Lake Village, AR
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
Specialties & Licenses
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Chicot Memorial Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
14Medicare enrollment records show 14 clinicians reassign Medicare billing to Chicot Memorial Medical Center, which bills Medicare for the services they deliver. Of these, 7 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (14)
Washington, DC 20019
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, ARCertificate of Compliance 04D0465387
Chicot Memorial Medical Center · Lake Village, ARFrequently 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.
Is Chicot Memorial Medical Center enrolled in Medicare?
Yes. Chicot Memorial Medical Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Chicot Memorial Medical Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians in 5 Medicare specialties reassign their Medicare billing to Chicot Memorial Medical Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (5), Nurse Practitioner (4) and Certified Registered Nurse Anesthetist (CRNA) (3). Of these, 7 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer 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.
# Chicot Memorial Medical Center · NPI 1003213281
Rural Health organization in Lake Village, Arkansas. Organization record, active in the CMS NPPES registry since December 3, 2014.
## Identity
- **NPI:** 1003213281 (Entity type: Organization)
- **Enumerated:** December 3, 2014
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Organization subpart:** No
- **Authorized official:** Susan Vaughn, CFO
## Practice location
- **Address:** 2729 HWY 65 & 82 S, Lake Village, AR 71653-6136
- **Phone:** (870) 265-5351 · **Fax:** (870) 265-2091
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 14 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (5), Nurse Practitioner (4), Certified Registered Nurse Anesthetist (CRNA) (3); 7 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 13, 2018
- **Other identifiers:** Other 04-1328; Medicaid 181080105 (AR); Other 04-Z328
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003213281) · Data from the CMS NPPES public registry.