NPIMap

Organization Active NPI

Baxter Regional Health System

Doing business as Baxter Health School Based Clinic

  • Family Medicine Physician
  • Bakersfield, MO
National Provider Identifier
1013745637
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BAXTER REGIONAL HEALTH SYSTEM
Doing business as
Baxter Health School Based Clinic
Practice address
357 State Highway O
Bakersfield, MO 65609-8483
Phone
(417) 284-7333
NPI assigned
Jul 24, 2024
Last updated
Jul 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Debra Henry
Title
Cfo
Phone
(870) 508-1003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

357 State Highway O
Bakersfield, MO 65609-8483

Mailing address

PO Box 2038
Mountain Home, AR 72654-2038
Phone (417) 284-7333

Other practice location 1

422 Bulldog Dr
Gainesville, MO 65655-7459
Phone (417) 284-7333

Other names 1

  • Baxter Health School Based Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190107000951 MO Part B Supplier - Clinic/Group Practice 0941507677 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bakersfield Mo, MO; West Plains, MO; Gainesville, MO; Thayer, MO

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
26D2309784Baxter Health School Based Clinic357 State Hwy O, Bakersfield, MO 65609Certificate of waiverAug 20, 2026

National Provider Directory

National Provider Directory
Tax ID family
Baxter Regional Health System8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

357 State Highway O
Bakersfield, MO 65609
Phone (417) 284-7333

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1013745637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2038",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726542038",
            "telephone_number": "417-284-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 STATE HIGHWAY O",
            "city": "BAKERSFIELD",
            "state": "MO",
            "postal_code": "656098483",
            "telephone_number": "417-284-7333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "422 Bulldog Dr",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "MO",
            "postal_code": "656557459",
            "country_code": "US",
            "telephone_number": "417-284-7333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BAXTER REGIONAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-508-1003"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baxter Health School Based Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bakersfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.