NPIMap

Organization Active NPI

Delta Memorial Hospital

  • Clinic/Center
  • Dumas, AR
National Provider Identifier
1083439012
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
DELTA MEMORIAL HOSPITAL
Practice address
103 W Waterman St
Dumas, AR 71639-2139
Phone
(870) 382-4303
NPI assigned
Nov 15, 2024
Last updated
Nov 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Authorized official

Name
Skye Wells
Title
Cfo
Phone
(870) 382-4303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

103 W Waterman St
Dumas, AR 71639-2139

Mailing address

PO Box 887
Dumas, AR 71639-0887

Other names 1

  • Delta Memorial Hospital MAT Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250103003302 AR Part B Supplier - Clinic/Group Practice 1658262241 Receives reassigned benefits from 3 practitioners
Practice locations: Dumas, AR

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Delta Memorial Hospital9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

300 Pickens St
Dumas, AR 71639
Phone (870) 382-0052

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/deltamh-91f47cd8

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1083439012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 887",
            "city": "DUMAS",
            "state": "AR",
            "postal_code": "716390887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W WATERMAN ST",
            "city": "DUMAS",
            "state": "AR",
            "postal_code": "716392139",
            "telephone_number": "870-382-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "SKYE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-382-4303"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta Memorial Hospital MAT Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dumas, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.