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MAINLINE HEALTH SYSTEMS, INC
NPI 1407650179
Specialist in Portland, AR

Active since April 02, 2025CLIA 04D0465422 · Accreditation
233 N MAIN ST, PORTLAND, AR 71663(870) 737-2221(855) 878-5991 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 18, 2026, Jun 12, 2025, May 15, 2025 and 2 more (5 updates tracked since 2025).

About Mainline Health Systems, Inc NPPES

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

MAINLINE HEALTH SYSTEMS, INC (NPI 1407650179) is a healthcare organization registered as a specialist in Portland, Arkansas and active in the NPI registry since April 2025. The organization holds an CLIA Accreditation certificate valid through June 2, 2028 and lists Gary Allan Nichols, Ceo, as its authorized official.

NPPES Registry Identity

NPI1407650179
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameMAINLINE HEALTH SYSTEMS, INC
Location Address233 N MAIN STPortland, AR 71663-9230
Mailing Address342 Highway 425 SMonticello, AR 71655-4612 · (870) 942-3000 · Fax (870) 942-3005
Phone(870) 737-2221
Fax(855) 878-5991
Organization SubpartNo
Authorized OfficialGary Allan NicholsCeo · (870) 942-3000
Enumeration DateApril 2, 2025
Last NPPES UpdateMay 18, 20265 updates tracked since enumeration
NPPES CertifiedMay 18, 2026
✔ NPI 1407650179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
233 N MAIN ST, Portland, AR 71663
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mainline Health Systems, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

63

Medicare enrollment records show 63 clinicians reassign Medicare billing to Mainline Health Systems, Inc, which bills Medicare for the services they deliver. Of these, 5 practice at this address. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 8

Nurse Practitioner36
Family Practice9
Clinical Social Worker8
Mental Health Counselor3
Dentist2
Obstetrics/Gynecology2
Registered Dietitian or Nutrition Professional2
Internal Medicine1

Nearest to this location (20)

See all 63
Ashley Ainsworth, FNP-C
Nurse Practitioner
NPI 1992630230
233 N MAIN ST
Portland, AR 71663
(870) 737-2221
✔ PECOS✔ Accepts MedicareSame address
Myra Flemister, APRN
Nurse Practitioner
NPI 1982128096
233 N MAIN ST
Portland, AR 71663
(870) 737-2221
✔ PECOS✔ Accepts MedicareSame address
Annie Haynes, LCSW
Clinical Social Worker
NPI 1932336054
233 N MAIN ST
Portland, AR 71663
(870) 737-2221
✔ PECOSSame address
Meredith Hudson, LPC
Mental Health Counselor
NPI 1043539075
233 N MAIN ST
Portland, AR 71663
(870) 737-2221
✔ PECOS✔ Accepts MedicareSame address
Byron Montgomery, ANP
Nurse Practitioner
NPI 1376841247
233 N MAIN ST
Portland, AR 71663
(870) 538-5414
✔ PECOSSame address
Cassidy Gavin Sanders, APRN
Nurse Practitioner
NPI 1144989500
579 E BEOUFF ST
Eudora, AR 71640
(870) 355-2512
✔ PECOS✔ Accepts Medicare16 mi
Kathryn Pippin, APRN
Nurse Practitioner
NPI 1780497909
579 E BEOUFF ST
Eudora, AR 71640
(870) 355-2512
✔ PECOS✔ Accepts Medicare16 mi
Rebekah Ayecock, PMHNP
Nurse Practitioner
NPI 1104251180
300 SOUTH SCHOOL ST
Dermott, AR 71638
(870) 538-3355
✔ PECOS✔ Accepts Medicare20 mi
Charlie Cruce
Nurse Practitioner
NPI 1962044800
300 S SCHOOL ST
Dermott, AR 71638
(870) 538-3355
✔ PECOS✔ Accepts Medicare20 mi
Shenika Jackson King, APRN
Nurse Practitioner
NPI 1669886552
300 S SCHOOL ST
Dermott, AR 71638
(870) 538-5296
✔ PECOS✔ Accepts Medicare20 mi
Courtney Johnson, CNP
Nurse Practitioner
NPI 1386026359
300 S SCHOOL ST
Dermott, AR 71638
(870) 538-5296
✔ PECOS✔ Accepts Medicare20 mi
Dana Phillips, FNP-BC
Nurse Practitioner
NPI 1659710879
300 S SCHOOL ST
Dermott, AR 71638
(870) 538-5296
✔ PECOS✔ Accepts Medicare20 mi
Kimberly Weeks, CNP
Nurse Practitioner
NPI 1205315637
300 S SCHOOL ST
Dermott, AR 71638
(870) 538-5296
✔ PECOS✔ Accepts Medicare20 mi
Katelan Welch, APRN
Nurse Practitioner
NPI 1730630849
300 S SCHOOL ST
Dermott, AR 71638
(870) 538-3355
✔ PECOS✔ Accepts Medicare20 mi
Terri Eubanks, DDS
Dentist
NPI 1306960737
300 S SCHOOL ST
Dermott, AR 71638
(870) 538-9720
✔ PECOS20 mi
Jesse Bone, CNP
Nurse Practitioner
NPI 1770039752
535 JORDAN DR
Monticello, AR 71655
(870) 367-6246
✔ PECOS✔ Accepts Medicare31 mi
Jennifer Cotton, CASE MANAGER
Clinical Social Worker
NPI 1811024276
535 JORDAN DR.
Monticello, AR 71655
(870) 367-6246
✔ PECOS✔ Accepts Medicare31 mi
Kristen Dent, M.D.
Family Practice
NPI 1881072791
535 JORDAN DR
Monticello, AR 71655
(870) 367-6246
✔ PECOS✔ Accepts Medicare31 mi
Leia O'fallon, ANP
Obstetrics/Gynecology
NPI 1477269306
535 JORDAN DR
Monticello, AR 71655
(870) 367-6246
✔ PECOS✔ Accepts Medicare31 mi
Jane Pelkki, RDN
Registered Dietitian or Nutrition Professional
NPI 1457577397
535 JORDAN DR
Monticello, AR 71655
(870) 367-6246
✔ Accepts Medicare31 mi
See all 63 clinicians

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 Accreditation 04D0465422

Mainline Health Systems Portland · Portland, AR
Active · expires Jun 2, 2028
CLIA Number04D0465422
Laboratory TypePhysician Office
Certificate Effective DateJune 3, 2026
Certificate Expiration DateJune 2, 2028
Laboratory DirectorDr. John Beatty
Laboratory Phone(870) 737-2221
Laboratory LocationMainline Health Systems Portland223 N Main Street, Portland, AR 71663
CLIA data matches this NPI record on: Name Phone
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.

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 Mainline Health Systems, Inc's NPI number?

The NPI number for Mainline Health Systems, Inc is 1407650179. It was assigned to this organization in the NPPES registry on April 2, 2025.

Where is Mainline Health Systems, Inc located?

Mainline Health Systems, Inc is located at 233 N Main St, Portland, AR 71663. The listed phone number is (870) 737-2221.

What is Mainline Health Systems, Inc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Mainline Health Systems, Inc enrolled in Medicare?

Yes. Mainline Health Systems, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mainline Health Systems, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 63 clinicians in 8 Medicare specialties reassign their Medicare billing to Mainline Health Systems, Inc. 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 Nurse Practitioner (36), Family Practice (9) and Clinical Social Worker (8). Of these, 5 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Mainline Health Systems, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 04D0465422) is associated with this NPI, valid through June 2, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mainline Health Systems, Inc was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.