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MAGNOLIA PEDIATRIC CLINIC, INC.
NPI 1396775797
Pediatrics in Magnolia, AR

Active since July 03, 2006
306 E MCNEIL, MAGNOLIA, AR 71753(870) 234-5171(870) 234-0507 Get Directions Write a Review

NPPES record last updated: February 20, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Magnolia Pediatric Clinic, Inc. NPPES

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

MAGNOLIA PEDIATRIC CLINIC, INC. (NPI 1396775797) is a healthcare organization registered as a pediatrics in Magnolia, Arkansas and active in the NPI registry since July 2006. The organization lists Amy Cross, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1396775797
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameMAGNOLIA PEDIATRIC CLINIC, INC.
Location Address306 E MCNEILMagnolia, AR 71753-2927
Mailing Address306 E McneilMagnolia, AR 71753-2927 · (870) 234-5171 · Fax (870) 234-0507
Phone(870) 234-5171
Fax(870) 234-0507
Organization SubpartNo
Authorized OfficialAmy CrossOwner/president · (870) 234-5171
Enumeration DateJuly 3, 2006
Last NPPES UpdateFebruary 20, 2012
✔ NPI 1396775797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in AR · E2147
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
306 E MCNEIL, Magnolia, AR 71753
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Other Identifiers 1

Medicaid140579002AR

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 SINGLE SPECIALTY GROUP

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 04D1057549

Magnolia Pediatric Clinic, Inc · Magnolia, AR
Expired · Aug 14, 2026
CLIA Number04D1057549
Laboratory TypePhysician Office
Certificate Effective DateAugust 15, 2024
Certificate Expiration DateAugust 14, 2026
Laboratory DirectorAmy Cross
Laboratory Phone(870) 234-5171
Laboratory LocationMagnolia Pediatric Clinic, Inc306 E Mcneil, 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.

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 Pediatric Clinic, Inc.'s NPI number?

The NPI number for Magnolia Pediatric Clinic, Inc. is 1396775797. It was assigned to this organization in the NPPES registry on July 3, 2006.

Where is Magnolia Pediatric Clinic, Inc. located?

Magnolia Pediatric Clinic, Inc. is located at 306 E Mcneil, Magnolia, AR 71753. The listed phone number is (870) 234-5171.

What is Magnolia Pediatric Clinic, Inc.'s specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Magnolia Pediatric Clinic, Inc. was last updated on February 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.