LAKE VILLAGE CLINIC PA
NPI 1306801212
Clinic/Center - Rural Health in Lake Village, AR
About Lake Village Clinic Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKE VILLAGE CLINIC PA (NPI 1306801212) is a healthcare organization registered as a rural health in Lake Village, Arkansas and active in the NPI registry since April 2006. The organization holds a CLIA Waiver certificate valid through August 7, 2027 and lists Suzanne Howell, Billing Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 2
Group Practice 1
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)
Lake Village Clinic Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Lake Village Clinic PA, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
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
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 04D0693694
Lake Village Clinic 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 Lake Village Clinic PA's NPI number?
The NPI number for Lake Village Clinic PA is 1306801212. It was assigned to this organization in the NPPES registry on April 20, 2006.
Where is Lake Village Clinic PA located?
Lake Village Clinic PA is located at 2918 Louis Sessions St, Lake Village, AR 71653. The listed phone number is (870) 265-5343.
What is Lake Village Clinic PA's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Lake Village Clinic PA enrolled in Medicare?
Yes. Lake Village Clinic PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lake Village Clinic PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Lake Village Clinic PA. 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 (3), Nurse Practitioner (3) and General Surgery (1). Of these, 2 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Lake Village Clinic PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D0693694) is associated with this NPI, valid through August 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Lake Village Clinic PA accept?
Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage, Octave and UnitedHealthcare list Lake Village Clinic PA 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 Lake Village Clinic PA was last updated on September 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Lake Village Clinic Pa · NPI 1306801212
Rural Health organization in Lake Village, Arkansas. Organization record, active in the CMS NPPES registry since April 20, 2006.
## Identity
- **NPI:** 1306801212 (Entity type: Organization)
- **Enumerated:** April 20, 2006
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Organization subpart:** No
- **Authorized official:** Suzanne Howell, BILLING MANAGER
## Practice location
- **Address:** 2918 LOUIS SESSIONS ST, Lake Village, AR 71653-6049
- **Phone:** (870) 265-5343 · **Fax:** (870) 265-5686
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 7 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (3), Nurse Practitioner (3), General Surgery (1); 2 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 27, 2024
- **Other identifiers:** Medicaid 101409002 (AR); Medicaid 127181729 (AR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1306801212) · Data from the CMS NPPES public registry.