<unavail> in Mountain Home, AR - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center) in Mountain Home, Arkansas. The current practice location for is 614 Broadmoor Dr, Mountain Home, Arkansas. For appointments, you can reach them via phone at (870) 508-3870. The mailing address for is 614 Broadmoor Dr, Mountain Home, Arkansas and phone number is (870) 508-3870.

is licensed to practice in Arkansas (license number ). The clinic also participates in the medicare program and its NPI number is 1437423472. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (870) 508-3870.

Contact Information


	614 Broadmoor Dr Mountain Home AR 72653-2903
	(870) 508-3870
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	614 Broadmoor Dr, Mountain Home, Arkansas
Authorized Official Name and Position	Debra Henry (CFO)
Authorized Official Contact	8705081003
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
614 Broadmoor Dr Mountain Home AR 72653-2903 Ph: (870) 508-3870	614 Broadmoor Dr Mountain Home AR 72653-2903 Ph: (870) 508-3870

NPI Details:

NPI Number	1437423472
Provider Enumeration Date	03/07/2012
Last Update Date	07/17/2023

Medicare PECOS Information:

Medicare PECOS PAC ID	3274420971
Medicare Enrollment ID	O20120525000458

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1437423472	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261Q00000X	Clinic/center	(Arkansas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Jessica J Johnson
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1114308707 PECOS PAC ID: 2062729494 Enrollment ID: I20150917002194

Provider Name	Haley Annette Tyler
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1114681053 PECOS PAC ID: 5294127544 Enrollment ID: I20220118000933

Provider Name	Jodi Nicole Bodenhamer
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1063162287 PECOS PAC ID: 9830577782 Enrollment ID: I20220604000363

Reviews and Comments

Clinic/Center in Mountain Home, AR

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- Medicare Primary Care in Mountain Home, AR