Baxter County Regional Hospital Inc
Organization Active NPI Obstetrics & Gynecology Physician · Mountain Home, AR
NPI 1093242018 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1093242018
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- BAXTER COUNTY REGIONAL HOSPITAL INC
- Practice address
- 628 Hospital Dr Ste 3B
Mountain Home, AR 72653-2953 - Phone
- (870) 508-6020
- Fax
- (870) 508-6025
- NPI assigned
- May 22, 2017
- Organization subpart
- No
Authorized official
- Name
- Debra Henry
- Title
- Cfo
- Phone
- (870) 508-1003
Other NPIs on the same Medicare enrollment 6
Practitioners 3
-
Zackary Shane Shearer, M.D.
-
William Corey Smith, M.D.
-
James Justin Yancey, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080514000435 | AR | Part B Supplier - Clinic/Group Practice | 0042389264 |
Receives reassigned benefits from 16 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mountain Home, AR; Harrison, AR |
National Provider Directory
Locations
505 Hospital Dr
Ste 1
Mountain Home, AR 72653
Phone (870) 508-3260
628 Hospital Dr
Ste 3B
Mountain Home, AR 72653
Phone (870) 508-6020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | Yes |
Addresses
Primary practice location
628 Hospital Dr Ste 3B
Mountain Home, AR 72653-2953
Mailing address
628 Hospital Dr Ste 3B
Mountain Home, AR 72653-2953
Phone (870) 508-6020
Other names
- BRMC Obstetrics & Gynecology
Other providers in Mountain Home, AR
- Baxter County Regional Hospital
- Baxter County Regional Hospital
- Baxter County Regional Hospital
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
- Baxter County Regional Hospital Inc
All providers in Mountain Home, AR · Obstetrics & Gynecology Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.