MOBLEY MEDICAL CLINIC PLLC
NPI 1871250555
Nurse Practitioner - Acute Care in El Dorado, AR
About Mobley Medical Clinic Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MOBLEY MEDICAL CLINIC PLLC (NPI 1871250555) is a healthcare organization registered as an acute care in El Dorado, Arkansas and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through November 2, 2027 and lists Jessica Pate Mobley, Member/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mobley Medical Clinic Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Mobley Medical Clinic PLLC, 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 04D2241913
Mobley Medical Clinic · El Dorado, 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 Mobley Medical Clinic PLLC's NPI number?
The NPI number for Mobley Medical Clinic PLLC is 1871250555. It was assigned to this organization in the NPPES registry on November 17, 2021.
Where is Mobley Medical Clinic PLLC located?
Mobley Medical Clinic PLLC is located at 708 S Timberlane Dr Ste A, El Dorado, AR 71730. The listed phone number is (870) 639-6465.
What is Mobley Medical Clinic PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Mobley Medical Clinic PLLC enrolled in Medicare?
Yes. Mobley Medical Clinic PLLC is registered in the Medicare PECOS enrollment system.
When is Mobley Medical Clinic PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arkansas, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Mobley Medical Clinic PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Mobley Medical Clinic PLLC. 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 Mobley Medical Clinic PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D2241913) is associated with this NPI, valid through November 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Mobley Medical Clinic PLLC 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 Mobley Medical Clinic PLLC 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 Mobley Medical Clinic PLLC was last updated on December 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.
# Mobley Medical Clinic Pllc · NPI 1871250555
Acute Care organization in El Dorado, Arkansas. Organization record, active in the CMS NPPES registry since November 17, 2021.
## Identity
- **NPI:** 1871250555 (Entity type: Organization)
- **Enumerated:** November 17, 2021
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **Organization subpart:** No
- **Authorized official:** Jessica Mobley, MEMBER/OWNER
## Practice location
- **Address:** 708 S TIMBERLANE DR STE A, El Dorado, AR 71730-6991
- **Phone:** (870) 639-6465 · **Fax:** (870) 639-6470
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Arkansas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) 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:** December 18, 2024
- **Other identifiers:** Other 1X1853 (AR); Medicaid 281608762 (AR)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1871250555) · Data from the CMS NPPES public registry.