NPIMap

Organization Active NPI

White River Health System, Inc.

Doing business as Sugarloaf Medical Clinic

  • Rural Health Clinic/Center
  • Heber Springs, AR
National Provider Identifier
1013451186
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WHITE RIVER HEALTH SYSTEM, INC.
Doing business as
Sugarloaf Medical Clinic
Practice address
521 Wilburn Rd
Heber Springs, AR 72543-8714
Phone
(501) 270-4200
NPI assigned
Dec 8, 2016
Last updated
May 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shawna Baxter
Title
Provider Enrollment
Phone
(870) 262-5545

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

521 Wilburn Rd
Heber Springs, AR 72543-8714

Mailing address

1710 Harrison St
Batesville, AR 72501-7303
Phone (501) 270-4200

Other names 1

  • SUGARLOAF MEDICAL CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170125002953 AR Part B Supplier - Clinic/Group Practice 0143134270 Receives reassigned benefits from 25 practitioners
Practice locations: Heber Springs, AR
O20210302002831 AR Part A Provider - Rural Health Clinic 0143134270 Practice locations: Heber Springs, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013451186. Details of each certification follow.

Rural health clinic certification: CCN 043914

Legal name
WHITE RIVER HEALTH SYSTEM, INC.
Doing business as
SUGARLOAF MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 14, 2021
Last certification
Apr 18, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 17, 1999 in AR
Enrollment address
521 Wilburn Rd
Heber Springs, AR 72543-8714

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2123684Sugarloaf Medical Clinic521 Wilburn Road, Heber Springs, AR 72543Certificate of waiverDec 27, 2026

National Provider Directory

National Provider Directory
Tax ID family
WRMC Patient Care Clini48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Crystal Johnson Individual Corporate OfficerSecretary Jan 1, 2026
White River Health System, Inc. Organization, Batesville, AR Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 1, 2021 100%
Stacy Gunderman Individual Corporate OfficerBoard Member Jan 1, 2026
Maggie Williams Individual Corporate DirectorExecutive Director Nov 1, 2025
Danny Bell Individual Corporate OfficerBoard Member Jan 1, 2026
Robert McIntire Individual Corporate OfficerTreasurer Jan 1, 2026
Elizabeth Christian Individual Corporate OfficerBoard Member Jan 1, 2026
Jason Taylor Individual Corporate OfficerBoard Member Jan 1, 2026
Tina Wheelis Individual Corporate OfficerBoard Member Jan 1, 2026
Shawna Baxter Individual W-2 Managing EmployeeDelegated Official Aug 28, 2023
Kevin S Rose Individual Corporate OfficerBoard Member Jan 1, 2026
Randy Cross Individual Corporate OfficerChairman Jan 1, 2026
Kathy Lanier Individual Corporate OfficerBoard Member Jan 1, 2026
Lisa Lambert Individual Corporate DirectorExecutive Director Jan 31, 2000
William Tyler Fowlkes Individual Corporate OfficerVice-Chairman Jan 1, 2026
Lance Lamberth Individual Corporate OfficerBoard Member Jan 1, 2026

All facility ownership & control disclosures 16

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
White River Medical CenterBatesville, AR, CCN 040119 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 31, 1976
Jan 31, 1976
Stone County Medical CenterMountain View, AR, CCN 041310 Hospital Operational/Managerial Control Jan 1, 2008
Stone County Medical CenterMountain View, AR, CCN 04Z310 Hospital 5% Or Greater Direct Ownership Interest Apr 1, 1999
White River Medical CenterBatesville, AR, CCN 04S119 Hospital Operational/Managerial Control Dec 21, 2007
White River Medical Center Rehabilitation UnitBatesville, AR, CCN 04T119 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1976
Midway Medical ClinicCherokee Village, AR, CCN 043981 Rural health clinic Operational/Managerial Control (100%) Sep 10, 2010
Melbourne Medical ClinicMelbourne, AR, CCN 043997 Rural health clinic Operational/Managerial Control Oct 16, 2007
Drasco Medical ClinicDrasco, AR, CCN 043455 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 1996
Cave City Medical ClinicCave City, AR, CCN 043982 Rural health clinic Operational/Managerial Control Nov 19, 1991
Plesant Plains Medical ClinicPleasant Plains, AR, CCN 043422 Rural health clinic Operational/Managerial Control Jul 1, 2006
White River Health Family CareMountain View, AR, CCN 043884 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2015
White River Health Family CareNewark, AR, CCN 048540 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Family CareBatesville, AR, CCN 048539 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Family CareSouthside, AR, CCN 048541 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Care FamilyBatesville, AR, CCN 048542 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2023
White River Health Children's ClinicBatesville, AR, CCN 048543 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2023

Facilities with the same owner 16

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 16

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1013451186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017303",
            "telephone_number": "501-270-4200",
            "fax_number": "501-270-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 WILBURN RD",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725438714",
            "telephone_number": "501-270-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE RIVER HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-08",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "870-262-5545"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUGARLOAF MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SUGARLOAF MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Heber Springs, AR

Sources for this page

Verify at the official NPI Registry.