NPIMap

Organization Active NPI

White River Health System, Inc.

  • Multi-Specialty Clinic/Center
  • Cherokee Village, AR
National Provider Identifier
1104642354
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
WHITE RIVER HEALTH SYSTEM, INC.
Practice address
197 Hospital Dr Ste B
Cherokee Village, AR 72529-7315
Phone
(870) 257-5118
Fax
(870) 257-6215
NPI assigned
Dec 3, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Shawna Baxter
Title
Provider Enrollment Specialist
Phone
(870) 257-5118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

197 Hospital Dr Ste B
Cherokee Village, AR 72529-7315

Mailing address

1710 Harrison St
Batesville, AR 72501-7303
Phone (870) 262-5545

Other names 1

  • WHITE RIVER HEALTH FAMILY MEDICINE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241224000418 AR Part B Supplier - Clinic/Group Practice 0143134270 Receives reassigned benefits from 8 practitioners
Practice locations: Cherokee Village, AR

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
04D0941101White River Health Family Medicine197 Hospital Drive Suite B, Cherokee Village, AR 72529Certificate of waiverDec 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
White Riv HLTH Syst Inc48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

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

View all 47

Locations

195 Hospital Dr
Ste C
Cherokee Vlg, AR 72529
Phone (870) 257-6040

Ownership & related parties

All facility ownership & control disclosures 17

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

FacilityTypeRoleSince
White River Medical CenterBatesville, AR, CCN 040119 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 31, 1976
Jan 31, 1976
Stone County Medical CenterMountain View, AR, CCN 041310 Hospital Operational/Managerial Control Jan 1, 2008
Stone County Medical CenterMountain View, AR, CCN 04Z310 Hospital 5% Or Greater Direct Ownership Interest Apr 1, 1999
White River Medical CenterBatesville, AR, CCN 04S119 Hospital Operational/Managerial Control Dec 21, 2007
White River Medical Center Rehabilitation UnitBatesville, AR, CCN 04T119 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1976
Midway Medical ClinicCherokee Village, AR, CCN 043981 Rural health clinic Operational/Managerial Control (100%) Sep 10, 2010
Melbourne Medical ClinicMelbourne, AR, CCN 043997 Rural health clinic Operational/Managerial Control Oct 16, 2007
Drasco Medical ClinicDrasco, AR, CCN 043455 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 1996
Cave City Medical ClinicCave City, AR, CCN 043982 Rural health clinic Operational/Managerial Control Nov 19, 1991
Plesant Plains Medical ClinicPleasant Plains, AR, CCN 043422 Rural health clinic Operational/Managerial Control Jul 1, 2006
White River Health Family CareMountain View, AR, CCN 043884 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2015
Sugarloaf Medical ClinicHeber Springs, AR, CCN 043914 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2021
White River Health Family CareNewark, AR, CCN 048540 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Family CareBatesville, AR, CCN 048539 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Family CareSouthside, AR, CCN 048541 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2023
White River Health Care FamilyBatesville, AR, CCN 048542 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2023
White River Health Children'S ClinicBatesville, AR, CCN 048543 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2023

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1104642354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017303",
            "telephone_number": "870-262-5545",
            "fax_number": "870-262-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 HOSPITAL DR STE B",
            "city": "CHEROKEE VILLAGE",
            "state": "AR",
            "postal_code": "725297315",
            "telephone_number": "870-257-5118",
            "fax_number": "870-257-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE RIVER HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "870-257-5118"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WHITE RIVER HEALTH FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cherokee Village, AR

Sources for this page

Verify at the official NPI Registry.