NPIMap

Organization Active NPI

Baxter Regional Health System

Doing business as Baxter Health Harrison Family Practice

  • Family Medicine Physician
  • Harrison, AR
National Provider Identifier
1063223089
Registry record updated Feb 11, 2025
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 Harrison Family Practice
Practice address
715 W Sherman Ave Ste G
Harrison, AR 72601-2737
Phone
(870) 741-8247
Fax
(870) 741-3933
NPI assigned
Jan 17, 2025
Last updated
Feb 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

715 W Sherman Ave Ste G
Harrison, AR 72601-2737

Mailing address

PO Box 707
Mountain Home, AR 72654-0707
Phone (870) 741-8247

Other names 1

  • Baxter Health Harrison Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160324000353 AR Part B Supplier - Clinic/Group Practice 0941507677 Receives reassigned benefits from 20 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Melbourne, AR; Harrison, AR; Mountain Home, AR; Mountain View, AR; Pocahontas, AR; Salem, AR; Mammoth Spring, AR; Cave City, AR…

Other NPIs on the same Medicare enrollment 8

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

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

406 N Willow St
Harrison, AR 72601
Phone (870) 741-3252

1019 E Main St
Melbourne, AR 72556
Phone (870) 368-4729

1506 E Main St
Melbourne, AR 72556
Phone (870) 368-4377

102 Mountain Place Dr
Ste C
Mountain View, AR 72560
Phone (870) 232-5315

624 Highway 62 W
Salem, AR 72576
Phone (870) 895-3817

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1063223089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 707",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726540707",
            "telephone_number": "870-741-8247",
            "fax_number": "870-741-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W SHERMAN AVE STE G",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012737",
            "telephone_number": "870-741-8247",
            "fax_number": "870-741-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER REGIONAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "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 Harrison Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.