MAIN STREET MEDICAL CLINIC, P.A.
NPI 1841298791
Internal Medicine in Benton, AR
About Main Street Medical Clinic, P.a. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAIN STREET MEDICAL CLINIC, P.A. (NPI 1841298791) is a healthcare organization registered as an internal medicine in Benton, Arkansas and active in the NPI registry since July 2005. The organization holds a CLIA Waiver certificate valid through November 16, 2027 and lists Sheryl Wilchman, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
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)
Main Street Medical Clinic, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Main Street Medical Clinic, P.A., which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 04D1019297
Main Street Medical · Benton, 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 Main Street Medical Clinic, P.A.'s NPI number?
The NPI number for Main Street Medical Clinic, P.A. is 1841298791. It was assigned to this organization in the NPPES registry on July 13, 2005.
Where is Main Street Medical Clinic, P.A. located?
Main Street Medical Clinic, P.A. is located at 722 N Main St, Benton, AR 72015. The listed phone number is (501) 315-0059.
What is Main Street Medical Clinic, P.A.'s specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Main Street Medical Clinic, P.A. enrolled in Medicare?
Yes. Main Street Medical Clinic, P.A. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Main Street Medical Clinic, P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Main Street Medical Clinic, P.A.. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Main Street Medical Clinic, P.A. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D1019297) is associated with this NPI, valid through November 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Main Street Medical Clinic, P.A. accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Main Street Medical Clinic, P.A. 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 Main Street Medical Clinic, P.A. was last updated on May 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Main Street Medical Clinic, P.a. · NPI 1841298791
Internal Medicine organization in Benton, Arkansas. Organization record, active in the CMS NPPES registry since July 13, 2005.
## Identity
- **NPI:** 1841298791 (Entity type: Organization)
- **Enumerated:** July 13, 2005
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Sheryl Wilchman, OFFICE MANAGER
## Practice location
- **Address:** 722 N MAIN ST, Benton, AR 72015-3337
- **Phone:** (501) 315-0059 · **Fax:** (501) 315-1320
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Internal Medicine) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 20, 2021
- **Other identifiers:** Medicaid 150521002 (AR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1841298791) · Data from the CMS NPPES public registry.