MEMORIAL MEDICAL CLINIC
NPI 1962719856
Family Medicine in Ashdown, AR
About Memorial Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MEMORIAL MEDICAL CLINIC (NPI 1962719856) is a healthcare organization registered as a family medicine in Ashdown, Arkansas and active in the NPI registry since September 2010. The organization holds a CLIA Waiver certificate valid through November 19, 2026 and lists Vicki Ann Keener, Adm. Assistant, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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)
Memorial Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Memorial Medical Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 04D2158098
Memorial Medical Clinic · Ashdown, 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 Little River Medical Center, Inc.'s NPI number?
The NPI number for Little River Medical Center, Inc. is 1962719856. It was assigned to this organization in the NPPES registry on September 13, 2010. The provider is doing business as Memorial Medical Clinic.
Where is Little River Medical Center, Inc. located?
Little River Medical Center, Inc. is located at 370 W Main St, Ashdown, AR 71822. The listed phone number is (870) 898-4100.
What is Little River Medical Center, Inc.'s specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Little River Medical Center, Inc. enrolled in Medicare?
Yes. Little River Medical Center, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Little River Medical Center, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Little River Medical Center, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Little River Medical Center, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 04D2158098) is associated with this NPI, valid through November 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Little River Medical Center, Inc. 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 Little River Medical Center, Inc. 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 Little River Medical Center, Inc. was last updated on November 10, 2023. 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.
# Memorial Medical Clinic · NPI 1962719856
Family Medicine organization in Ashdown, Arkansas. Organization record, active in the CMS NPPES registry since September 13, 2010.
## Identity
- **NPI:** 1962719856 (Entity type: Organization)
- **Enumerated:** September 13, 2010
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Little River Medical Center, Inc.
- **Organization subpart:** Yes (part of Little River Medical Center, Inc.)
- **Authorized official:** Vicki Keener, ADM. ASSISTANT
## Practice location
- **Address:** 370 W MAIN ST, Ashdown, AR 71822-2750
- **Phone:** (870) 898-4100 · **Fax:** (870) 898-5791
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 10, 2023
- **Other identifiers:** Other 5G384 (AR); Medicaid 191446002 (AR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1962719856) · Data from the CMS NPPES public registry.