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JEFFERSON REGIONAL MONTICELLO MEDICAL CLINIC
NPI 1104587526
Family Medicine in Monticello, AR

Active since January 07, 2022CLIA Certified · 2 labs
906 ROBERTS DRIVE, SUITE B, MONTICELLO, AR 71655(870) 367-1461 Get Directions Write a Review

NPPES record last updated: April 1, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jefferson Regional Monticello Medical Clinic NPPES

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

JEFFERSON REGIONAL MONTICELLO MEDICAL CLINIC (NPI 1104587526) is a healthcare organization registered as a family medicine in Monticello, Arkansas and active in the NPI registry since January 2022. The organization holds 2 active CLIA laboratory certificates and lists Shayla Robinson, Corporate Compliance Officer, as its authorized official.

NPPES Registry Identity

NPI1104587526
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameJEFFERSON HOSPITAL ASSOCIATION, INC
Location Address906 ROBERTS DRIVE, SUITE BMonticello, AR 71655-5724
Mailing AddressPo Box 2650Pine Bluff, AR 71613-2650
Phone(870) 367-1461
Organization SubpartNo
Authorized OfficialShayla RobinsonCorporate Compliance Officer · (870) 541-7395
Enumeration DateJanuary 7, 2022
Last NPPES UpdateApril 1, 2022
NPPES CertifiedApril 1, 2022
✔ NPI 1104587526 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
906 ROBERTS DRIVE, Monticello, AR 71655
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Other Names 1

Other NameJefferson Regional Monticello Medical Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

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 Accreditation 04D0465417

Jefferson Regional Monticello Medical Clinic · Monticello, AR
Active · expires Dec 22, 2027
CLIA Number04D0465417
Laboratory TypePhysician Office
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorMrs. Elizabeth Whitaker
Laboratory Phone(870) 367-6867
Laboratory LocationJefferson Regional Monticello Medical Clinic906 Roberts Drive, Monticello, AR 71655
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 04D2176842

Jefferson Regional Monticello Medical Clinic 2 · Monticello, AR
Active · expires Dec 26, 2027
CLIA Number04D2176842
Laboratory TypeRural Health Clinic
Certificate Effective DateDecember 27, 2025
Certificate Expiration DateDecember 26, 2027
Laboratory DirectorMs. Elizabeth Whitaker
Laboratory Phone(870) 460-4766
Laboratory LocationJefferson Regional Monticello Medical Clinic 2733 Roberts Drive, Monticello, AR 71655
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

JULIA DANIELLE NICHOLSON M.D.
Family Medicine
906 ROBERTS DRIVE
MONTICELLO, AR 71655
Drew County (870) 367-6867

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 Jefferson Hospital Association, Inc's NPI number?

The NPI number for Jefferson Hospital Association, Inc is 1104587526. It was assigned to this organization in the NPPES registry on January 7, 2022. The provider is also known as Jefferson Regional Monticello Medical Clinic.

Where is Jefferson Hospital Association, Inc located?

Jefferson Hospital Association, Inc is located at 906 Roberts Drive Suite B, Monticello, AR 71655. The listed phone number is (870) 367-1461.

What is Jefferson Hospital Association, Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Jefferson Hospital Association, Inc 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 Jefferson Hospital Association, Inc 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 Jefferson Hospital Association, Inc 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 Jefferson Hospital Association, Inc was last updated on April 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.