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Baxter County Regional Hospital, Inc

Organization Active NPI Rural Health Clinic/Center · Yellville, AR

NPI 1023042991 · NPPES record last updated Jul 24, 2026

Key facts

NPI
1023042991
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
License
AR3827 (AR)
Legal business name
BAXTER COUNTY REGIONAL HOSPITAL, INC
Practice address
414 W Old Main St
Yellville, AR 72687-8284
Phone
(870) 449-4221
Fax
(870) 449-6777
NPI assigned
Jul 10, 2006
Organization subpart
Yes
Parent organization (as reported)
BAXTER COUNTY REGIONAL HOSPITAL, INC

Authorized official

Name
Debra Henry
Title
Chief Financial Officer
Phone
(870) 508-1003

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 7

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

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 39

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

View all 39

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 58

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 58

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in AR

Rural health clinic certification: CCN 043432

Legal name
BAXTER COUNTY REGIONAL HOSPITAL INC
Doing business as
BAXTER HEALTH AHRENS FAMILY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 15, 1995
Last certification
Jul 2, 2018
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Nov 1, 1963 in AR
Enrollment address
414 W Old Main St
Yellville, AR 72687-8284
Related CCNs
040027

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Rondell Peterson
Individual 		Corporate Director
President/Ceo		 Sep 1, 2008
Debra Henry
Individual 		Corporate Director Jul 12, 2015
Lucinda Crow
Individual 		W-2 Managing Employee
System Contract Analyst		 Jul 12, 2015
Nicole Vaccarella
Individual 		Corporate Director
VP/General Councel		 Dec 2, 2016

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Baxter Health
Mountain Home, AR · CCN 040027		 Hospital Operational/Managerial Control Nov 1, 1966
Baxter Health Family Clinic at Calico Rock
Calico Rock, AR · CCN 048559		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Baxter Health Family Clinic
Mountain Home, AR · CCN 048558		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Baxter Health Family Clinic at Melbourne
Melbourne, AR · CCN 048555		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025
Baxter Health Family Clinic at Mountain View
Mountain View, AR · CCN 048556		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025
Baxter Health Market Street Family Clinic
Mountain Home, AR · CCN 048557		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050607001085 AR Part B Supplier - Clinic/Group Practice 3274420971 Receives reassigned benefits from 32 practitioners
7 other NPIs on this enrollment
Practice locations: Calico Rock, AR; Harrison, AR; Mammoth Spring, AR; Melbourne, AR; Mountain Home, AR; Mountain View, AR; Yellville, AR
O20080129000496 AR Part a Provider - Rural Health Clinic 3274420971 Practice locations: Yellville, AR

National Provider Directory

Tax ID family
BCRH ER Prof Fees (40 organizations share this tax ID)
Part of
BCRH ER Prof Fees

Locations

203 Cotter Rd
Gassville, AR 72635
Phone (870) 404-0904

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X AR3827 AR
Rural Health Clinic/Center 261QR1300X AR3827 AR Yes

Addresses

Primary practice location

414 W Old Main St
Yellville, AR 72687-8284

Mailing address

PO Box 707
Mountain Home, AR 72654-0707
Phone (870) 424-7070

Other identifiers

IdentifierTypeStateIssuer
175567002MedicaidAR
127549729MedicaidAR
13432OtherARARKANSAS BCBS

Other names

  • Baxter Health Ahrens Family Clinic Doing business as

Other providers in Yellville, AR

All providers in Yellville, AR · Rural Health Clinic/Center in Arkansas

Sources for this page

Verify at the official NPI Registry.