UNIVERSITY OF ARKANSAS AT MONTICELLO
NPI 1083269690
General Practice in Monticello, AR

NPI Status: Active since August 09, 2019

Contact Information

663 UNIVERSITY DRIVE
MONTICELLO, AR
ZIP 71656
Phone: (870) 460-1058

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  • Organization
  • General Practice
  • CLIA Number: 04D1073726
  • CLIA Cert. Type: School/Student Health Service
  • CLIA Exp. Date: 09-13-2027

About UNIVERSITY OF ARKANSAS AT MONTICELLO

This page provides the complete NPI Profile along with additional information for University Of Arkansas At Monticello, a primary care provider established in Monticello, Arkansas operating as a General Practice. The healthcare provider is registered in the NPI registry with number 1083269690 assigned on August 2019. The practitioner's primary taxonomy code is 208D00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. University Of Arkansas At Monticello operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mouzon Bass Iii (Administrator/agent)

NPI
1083269690
Provider Name
UNIVERSITY OF ARKANSAS AT MONTICELLO
Entity Type
Organization
Location Address
663 UNIVERSITY DRIVE MONTICELLO, AR 71656
Location Phone
(870) 460-1058
Mailing Address
5050 SPRING VALLEY RD DALLAS, TX 75244
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-09-2019
Last Update Date
08-09-2019
Code Navigator

A primary care provider (PCP) like University Of Arkansas At Monticello sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

General Practice

Taxonomy Code
208D00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MOUZON BASS III

Authorized Official Title
ADMINISTRATOR/AGENT
Authorized Official Phone
(972) 367-4845

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
04D1073726
Facility Type
School/Student Health Service
Certificate Effective Date
September 14, 2025
Certificate Expiration Date
September 13, 2027
Laboratory Director
TERRI RICHARDSON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to University Of Arkansas At Monticello to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1083269690, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
3
Unchanged
Pos 5
2
Doubled → 4
Pos 6
6
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
6
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 2 → 4 9 → 18 → 9 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 6 + 3 + 4 + 6 + 1 + 8 + 6 + 1 + 8 + 24 = 70

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1083269690.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083269690, enumerated as an "organization" on August 09, 2019.

The provider is located at 663 UNIVERSITY DRIVE MONTICELLO, AR 71656 and the phone number is (870) 460-1058.

General Practice with taxonomy code 208D00000X.