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MAGNOLIA SURGERY CENTER, LLC
NPI 1043565542
Clinic/Center - Ambulatory Surgical in Magnolia, AR

Active since July 20, 2012CLIA 04D2044486 · Waiver
25 COLUMBIA ROAD 47, MAGNOLIA, AR 71753(870) 234-5665(870) 234-5665 Get Directions Write a Review

NPPES record last updated: August 20, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Magnolia Surgery Center, Llc NPPES

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

MAGNOLIA SURGERY CENTER, LLC (NPI 1043565542) is a healthcare organization registered as an ambulatory surgical in Magnolia, Arkansas and active in the NPI registry since July 2012. The organization holds a CLIA Waiver certificate valid through July 24, 2028 and lists Ivory A Kinslow, Owner/medical Director, as its authorized official.

NPPES Registry Identity

NPI1043565542
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameMAGNOLIA SURGERY CENTER, LLC
Location Address25 COLUMBIA ROAD 47Magnolia, AR 71753
Mailing Address25 Columbia Road 47Magnolia, AR 71753 · (870) 234-5665 · Fax (879) 234-5665
Phone(870) 234-5665
Fax(870) 234-5665
Organization SubpartNo
Authorized OfficialIvory A KinslowOwner/medical Director · (870) 234-5665
Enumeration DateJuly 20, 2012
Last NPPES UpdateAugust 20, 2025
NPPES CertifiedAugust 20, 2025
✔ NPI 1043565542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
25 COLUMBIA ROAD 47, Magnolia, AR 71753
Open in Google Maps ↗

Other Identifiers 1

Other295574AR · Medicare Ptan

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Magnolia Surgery Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateArkansasEnrollment IDO20130802000384Non-DME Part B · Ambulatory Surgical CenterDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Magnolia Surgery Center, LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (3)

Daniel Schrader, MD
Cardiovascular Disease (Cardiology)
NPI 1689634982
431 THOMPSON AVE
El Dorado, AR 71730
(870) 864-6700
✔ PECOS✔ Accepts Medicare32 mi
Ivory Kinslow, MD
Ophthalmology
NPI 1972575702
443 W OAK ST
El Dorado, AR 71730
(870) 862-2340
✔ PECOS✔ Accepts Medicare32 mi
Harvinder Dod, MD
Cardiovascular Disease (Cardiology)
NPI 1699983635
403 W OAK ST STE 101
El Dorado, AR 71730
(870) 875-1481
✔ PECOS✔ Accepts Medicare32 mi

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

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 04D2044486

Magnolia Surgery Center, LLC · Magnolia, AR
Active · expires Jul 24, 2028
CLIA Number04D2044486
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJuly 25, 2026
Certificate Expiration DateJuly 24, 2028
Laboratory DirectorIvory A. Kinslow
Laboratory Phone(870) 234-5665
Laboratory LocationMagnolia Surgery Center, LLC25 Columbia, Road 47, Magnolia, AR 71753
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
382 services219 patients
Injection, bimatoprost, intracameral implant, 1 microgram J7351
This procedure involves placing a tiny implant inside the eye, which releases a drug called bimatoprost. This drug helps to lower high pressure in the eye, typically seen in conditions like glaucoma. It's a safe and effective treatment.
270 services14 patients
Complex removal of cataract with insertion of prosthetic lens 66982
This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.
50 services38 patients
Injection of medication into eye 66030
This procedure involves administering medication directly into your eye. A tiny needle is used to deliver the drug into the vitreous, a jelly-like substance in the eye. It helps treat conditions like macular degeneration or diabetic retinopathy. It's generally safe and effective.
27 services14 patients
Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye 66991
This is a two-part eye procedure. First, a cloudy lens (cataract) is removed from its outer layer and replaced with an artificial lens to improve vision. Second, a drainage device is inserted into the front part of the eye to manage fluid levels, preventing pressure build-up.
26 services18 patients

Patient Reviews User submitted

Reviews are submitted by site visitors and approved by a human moderator before publication.

Review by Roland ***** October 19, 2025

5/5
As a person that has not had any medical problems (other than being over - weight ), I was very nervous about the procedure. Especially the part where I needed to have an I.V. inserted. When I finally arrived in the inside medical prep room, my nurse was 100% effective in calming me down,(even though I stated that I was fine). In addition, The I.V. nurse was a Super Pro, I can't thank her enough!
Provider 5/5 Office Staff 4/5
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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 Magnolia Surgery Center, LLC's NPI number?

The NPI number for Magnolia Surgery Center, LLC is 1043565542. It was assigned to this organization in the NPPES registry on July 20, 2012.

Where is Magnolia Surgery Center, LLC located?

Magnolia Surgery Center, LLC is located at 25 Columbia Road 47, Magnolia, AR 71753. The listed phone number is (870) 234-5665.

What is Magnolia Surgery Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Is Magnolia Surgery Center, LLC enrolled in Medicare?

Yes. Magnolia Surgery Center, LLC is registered in the Medicare PECOS enrollment system.

When is Magnolia Surgery Center, LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arkansas, Ambulatory Surgical Center) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Magnolia Surgery Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Magnolia Surgery Center, LLC, in Cardiovascular Disease (Cardiology) and Ophthalmology. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Magnolia Surgery Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2044486) is associated with this NPI, valid through July 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Magnolia Surgery Center, LLC 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 4 other insurers list Magnolia Surgery Center, LLC 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 Magnolia Surgery Center, LLC was last updated on August 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.